title: Repeated dengue shock syndrome and 'dengue myocarditis' responding dramatically to a single dose of methyl prednisolone.
abstract: The place of steroids in the management of severe forms of dengue is unclear. A retrospective observational study showed the benefits of a single dose of intravenous methyl prednisolone in a highly selected group of patients who developed severe dengue during the febrile phase of infection. We report the case of a 14-year-old boy with dengue who developed three episodes of severe hemodynamic compromise while having high fever, 'myocarditis', third space fluid accumulation, progressive reduction in urine output, and altered mentation, who made a dramatic recovery following a single dose of intravenous methyl prednisolone. Results justify a well powered randomized controlled trial to evaluate the efficacy of this treatment in severe dengue.
authors.affiliation: Department of Medicine, Faculty of Medicine, University of Kelaniya, Ragama, Sri Lanka. ranjanp64@gmail.com
authors.forename: R
authors.initials: R
authors.lastname: Premaratna
authors.forename: K M D J
authors.initials: KM
authors.lastname: Rodrigo
authors.forename: A
authors.initials: A
authors.lastname: Anuratha
authors.forename: V K D
authors.initials: VK
authors.lastname: de Alwis
authors.forename: U D C A
authors.initials: UD
authors.lastname: Perera
authors.forename: H J
authors.initials: HJ
authors.lastname: de Silva
mesh_terms: D000293:Adolescent; D003715:Dengue / Q000150:complications / Q000188:drug therapy* / Q000821:virology; D005938:Glucocorticoids / Q000008:administration & dosage / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008775:Methylprednisolone / Q000008:administration & dosage / Q000627:therapeutic use; D009205:Myocarditis / Q000188:drug therapy* / Q000821:virology; D019595:Severe Dengue / Q000188:drug therapy* / Q000628:therapy / Q000821:virology; D016896:Treatment Outcome
chemical_list: D005938:Glucocorticoids; D008775:Methylprednisolone