Soroy Lardo1, Yaldiera Utami2, Benediktus Yohan3, Seri Mmu Tarigan2, Widayat Djoko Santoso4, Leonard Nainggolan4, R Tedjo Sasmono5. 1. Division of Tropical Medicine and Infectious Diseases, Department of Internal Medicine, Gatot Soebroto Central Army Hospital, Jakarta, Indonesia. 2. Department of Internal Medicine, Faculty of Medicine, University of Indonesia, Jakarta, Indonesia. 3. Eijkman Institute for Molecular Biology, Jakarta, Indonesia. 4. Division of Tropical Medicine and Infectious Diseases, Department of Internal Medicine, Cipto Mangunkusumo National Central Hospital, Jakarta, Indonesia. 5. Eijkman Institute for Molecular Biology, Jakarta, Indonesia. Electronic address: sasmono@eijkman.go.id.
Abstract
OBJECTIVE: To describe the clinical manifestation of patient with severe dengue, to identify the serotypes and genotypes of dengue viruses (DENV) which concurrently infecting the patient, and to explore the possible relationship of severe dengue with the concurrent infection of DENV. METHODS: Dengue diagnosis was performed using NS1 antigen detection and IgG/IgM ELISA. Standard clinical and laboratory examinations were performed to obtain the clinical and hematological data. DENV concurrent infections were detected and confirmed using RT-PCR and DENV Envelope gene sequencing. Phylogenetic analyses were performed to determine the genotypes of the viruses. RESULTS: The patient was classified as having severe dengue characterized by severe plasma leakage, hemorrhage, and organ damage involving lung, liver, and kidney. Concurrent infection of DENV serotype 2 and 3 was observed. The infecting DENV-2 virus was grouped into Cosmopolitan genotype while DENV-3 virus was classified into Genotype I. Both viruses were closely related to isolates that were endemic in Jakarta. Viremia measurement was conducted and revealed a significantly higher virus titer of DENV-3 compared to DENV-2. CONCLUSIONS: The occurrence of multi-serotype DENV infections was presented in a patient with severe clinical manifestation in Indonesia. The hyperendemicity of dengue in Indonesia may contribute to the DENV concurrent infections cases and may underlie the severity of the disease.
OBJECTIVE: To describe the clinical manifestation of patient with severe dengue, to identify the serotypes and genotypes of dengue viruses (DENV) which concurrently infecting the patient, and to explore the possible relationship of severe dengue with the concurrent infection of DENV. METHODS: Dengue diagnosis was performed using NS1 antigen detection and IgG/IgM ELISA. Standard clinical and laboratory examinations were performed to obtain the clinical and hematological data. DENV concurrent infections were detected and confirmed using RT-PCR and DENV Envelope gene sequencing. Phylogenetic analyses were performed to determine the genotypes of the viruses. RESULTS: The patient was classified as having severe dengue characterized by severe plasma leakage, hemorrhage, and organ damage involving lung, liver, and kidney. Concurrent infection of DENV serotype 2 and 3 was observed. The infecting DENV-2 virus was grouped into Cosmopolitan genotype while DENV-3 virus was classified into Genotype I. Both viruses were closely related to isolates that were endemic in Jakarta. Viremia measurement was conducted and revealed a significantly higher virus titer of DENV-3 compared to DENV-2. CONCLUSIONS: The occurrence of multi-serotype DENV infections was presented in a patient with severe clinical manifestation in Indonesia. The hyperendemicity of dengue in Indonesia may contribute to the DENV concurrent infections cases and may underlie the severity of the disease.
Authors: I Made Susila Utama; Nurhayati Lukman; Dewi Dian Sukmawati; Bachti Alisjahbana; Anggraini Alam; Dewi Murniati; I Made Gede Dwi Lingga Utama; Dwiyanti Puspitasari; Herman Kosasih; Ida Laksono; Muhammad Karyana; Mulya Rahma Karyanti; M M D E A H Hapsari; Ninny Meutia; C Jason Liang; Wahyu Nawang Wulan; Chuen-Yen Lau; Ketut Tuti Merati Parwati Journal: PLoS Negl Trop Dis Date: 2019-10-21
Authors: P D N N Sirisena; Shakuntala Mahilkar; Chetan Sharma; Jaspreet Jain; Sujatha Sunil Journal: Indian J Med Res Date: 2021-05 Impact factor: 5.274
Authors: Arthur da Costa Rasinhas; Fernanda Cunha Jácome; Gabriela Cardoso Caldas; Ana Luisa Teixeira de Almeida; Marcos Alexandre Nunes da Silva; Daniel Dias Coutinho de Souza; Amanda Carlos Paulino; Derick Mendes Bandeira; Raphael Leonardo; Priscila Conrado Guerra Nunes; Ronaldo Mohana-Borges; Ortrud Monika Barth; Flavia Barreto Dos Santos; Debora Ferreira Barreto Vieira Journal: Viruses Date: 2021-09-29 Impact factor: 5.048