{"doi":"10.1093/infdis/jiac165","title":"Predominance of Severe Plasma Leakage in Pediatric Patients With Severe Dengue in Puerto Rico","abstract":"BACKGROUND: We evaluated clinical and laboratory findings among patients with nonsevere or severe dengue in Puerto Rico to examine whether clinical manifestations vary by age. METHODS: During 2012-2014, we enrolled patients who arrived at the emergency department with fever or history of fever within 7 days of presentation. Serum samples were tested for dengue virus (DENV) by reverse transcriptase-polymerase chain reaction (RT-PCR) and IgM enzyme-linked immunosorbent assay (ELISA). Severe dengue was defined as severe plasma leakage or shock, severe bleeding, or organ involvement at presentation, during hospitalization, or follow-up. RESULTS: Of 1089 dengue patients identified, 281 (26%) were severe. Compared to those with nonsevere dengue, patients with severe dengue were more often aged 10-19 years (55% vs 40%, P < .001) and hospitalized (87% vs 30%, P < .001). Severe plasma leakage or shock was more common among children aged 0-9 (59%) or 10-19 years (86%) than adults (49%) (P < .01). Severe bleeding was less common among 10-19 year olds (24%) compared to 0-9 year olds (45%) and adults (52%; P < .01). CONCLUSIONS: Severe plasma leakage was the most common presentation among children, highlighting important differences from adults. Vaccination against dengue could help prevent severe dengue among children in Puerto Rico.","journal":"The Journal of Infectious Diseases","year":2022,"id":270129,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":14,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.967,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2022-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":933835,"name":"Liliana Sánchez‐González","orcid":"0000-0001-8289-8587","position":1,"is_corresponding":false},{"id":933836,"name":"Brenda Torres-Velásquez","orcid":"0000-0003-3396-7915","position":2,"is_corresponding":false},{"id":313632,"name":"Emma Jones","orcid":"0000-0002-0108-6710","position":3,"is_corresponding":false},{"id":306898,"name":"Janice Pérez‐Padilla","orcid":"0000-0003-2612-8099","position":4,"is_corresponding":false},{"id":306892,"name":"Tyler M. Sharp","orcid":"0000-0002-7131-8257","position":5,"is_corresponding":false},{"id":933837,"name":"Olga Lorenzi","orcid":"0000-0003-4077-0424","position":6,"is_corresponding":false},{"id":933838,"name":"Mark Delorey","orcid":"0000-0002-3401-5433","position":7,"is_corresponding":false},{"id":306899,"name":"Jorge L. Muñoz‐Jordán","orcid":"0000-0002-1596-8343","position":8,"is_corresponding":false},{"id":306901,"name":"Kay M. Tomashek","orcid":"0000-0001-7741-7072","position":9,"is_corresponding":false},{"id":554331,"name":"Stephen H. Waterman","orcid":"0000-0003-4194-7914","position":10,"is_corresponding":false},{"id":933839,"name":"Luisa I. Alvarado","orcid":"0000-0002-1905-1524","position":11,"is_corresponding":false},{"id":425794,"name":"Vanessa Rivera‐Amill","orcid":"0000-0003-4810-0871","position":12,"is_corresponding":false},{"id":374740,"name":"Gabriela Paz‐Bailey","orcid":"0000-0001-8478-4911","position":0,"is_corresponding":true}],"reference_count":28,"raw_metadata":null,"created_at":"2026-07-19T00:27:26.772098Z","pmid":"35510941","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}