Dengue Shock Research Articles

Differentiating Shock Associated with Multi-inflammatory Syndrome in COVID-19 and Dengue – A Case Report

In India where dengue is endemic, differentiating dengue shock and shock due to multi-inflammatory syndrome in COVID become important. Only a few case reports of such cases are present in the literature and we describe a child who was being managed as dengue developed shock and fitted in definition of multisystem inflammatory syndrome in children (MIS-C). She had positive for dengue NS1 and had raised COVID-19 antibodies. Her capillary refill time was prolonged and her blood pressure was 72/37 mm of Hg. In view of shock, she was given fluid bolus and started on adrenaline infusion. She was given intravenous immunoglobulin and methyl prednisolone. With this management, she improved. When we consider type of shock in dengue, it is narrow pulse pressure, while in our child, this was wide pulse pressure. Hence, we decided to treat with inotropes after initial fluid bolus of 20 mL/kg. We conclude that while differentiating dengue shock from MIS-C shock, pulse pressure may be important adjunct.

Comparison of cardiac marker profiles in dengue myocarditis

Dengue patients may experience some grade of severity. Cardiac involvement is common in severe dengue, therefore cardiac markers could be used to ensure the diagnosis of dengue myocarditis. However, information of the cardiac marker profiles in patients with milder severity of dengue infection is limited. The study aimed to evaluate creatinine kinase (CK), creatinine kinase-MB (CK-MB) and troponin I (TnI) in dengue myocarditis against the spectrum severity of dengue infection in children. This cross-sectional study was conducted using secondary data from medical records of dengue myocarditis patients aged 1-18 yr in Dr. Sardjito General Hospital, Yogyakarta. Fisher’s Exact tests were performed to compare the increase in cardiac markers to the dengue severity. The increase of CK was observed in dengue fever/DF (6 or 75% of patients), dengue hemorrhagic fever/DHF (6 or 67%) and dengue shock syndrome/DSS (16 or 73%). Furthermore, the increase of CK-MB was also observed in DF (6 or 75%), DHF (8 or 87%), and DSS (21 or 95%). No significant difference in the increase of CK and CK-MB proportions was observed in DF compared to DHF groups and in DF compared to DSS (p>0.05). The increase of Tn I was observed in DHF (2 or 22%) and DSS (10 or 45%) groups but not observed in DF group. Significant difference in the increase of Tn I proportion was observed in DF compared to DSS groups (p=0.022). In conclusion, cardiac involvement is common in all dengue severity level. The increment of Tn I corresponds to an increase in the dengue severity level. Further research by observing cardiac markers sequentially is needed.

Neonatal Dengue- A Case Series

Dengue is one of the commonest arboviral infections seen in children but in neonates, it is a disregarded entity. It can be acquired either through vertical (transplacental) or horizontal transmission (mosquito bite). It usually presents with fever, lethargy, poor feeding, and thrombocytopenia which can be accompanied by hepatosplenomegaly, transaminitis, fluid leak, petechiae, bleeding, Acute Respiratory Distress Syndrome (ARDS), shock and Acute Kidney Injury (AKI). Dengue shock in neonates responds well to dopamine if used early. A retrospective review of case records of five neonates admitted with dengue fever from October 2021 to October 2022 showed the neonates average age was 10 days and male:female ratio of 3:2. Three cases had horizontal and two cases had vertical transmission. All neonates presented with fever and were admitted within one week of illness. Petechial rashes and refusal of feeds were observed in two cases. Four cases had leukopenia whereas, all cases had thrombocytopenia. Sepsis was ruled out. Dengue Nonstructural protein 1 (NS1) antigen was positive in four cases. IgM antibody was positive in all while IgG was negative in all cases. None of the cases had hepatic derangement except for mild transaminitis in three cases. Only two cases had severe thrombocytopenia requiring platelet transfusion, but none developed bleeding, plasma leakage, shock requiring inotropes or fluid overload. Mortality due to neonatal dengue was nil and the duration of hospital stay ranged between 6-12 days. In the vertically transmitted cases, isolation of the virus from the breast milk or cord blood was not done due to logistics. Therefore, dengue fever can be suspected as one of the differentials in any neonate presenting with fever, leukopenia, and thrombocytopenia mimicking sepsis, especially during the epidemic season.

Frequency of Plasma Leak in Patients with Dengue Fever

Objective: To find out the frequency of plasma leak as evident by pleural effusion and ascites in the patients of dengue fever. Study Design: Cross-sectional study. Place and Duration: Medical unit of Hayatabad Medical Complex, Peshawar Pakistan from April 2021 to September 2021. Methodology: Patients diagnosed as having dengue fever based on positive dengue antigen (NS 1) test or antibodies serology on enzyme linked immunosorbent assay (ELISA) were evaluated. Plasma leak was defined as having ascites or pleural effusion evident on ultrasound or X ray chest of the patients with active dengue fever. Hematocrit of >50% in female and 55% in male was considered as indirect indicator of plasma leak. Results: In a total of 154 patients, 89 (57.8%) were male and 65 (42.2%) female with age ranging between 14 to 75 years while mean age was 40.6±15.54 years. The over all frequency of plasma leak as evident by ascites or pleural effusion was 44.2% (n=68. The minimum duration in which plasma leak was noted, remained 4 days while the maximum was 8 days after the start of illness. The duration of patient’s hospital stay was 5 to 17 days (mean 9.53±3.43 days). Practical implications: The frequency of plasma leak was higher in complicated dengue fever patients as compared to patients with less or no complications. Conclusion: Plasma leak is an important and frequent feature of dengue fever. X ray chest and ultrasound can detect majority of plasma leak in patients with hemoconcentration. Keywords: dengue fever, plasma leak, dengue NS1, dengue shock, dengue hemorrhage

A modified Sequential Organ Failure Assessment score for dengue: development, evaluation and proposal for use in clinical trials

BackgroundDengue is a neglected tropical disease, for which no therapeutic agents have shown clinical efficacy to date. Clinical trials have used strikingly variable clinical endpoints, which hampers reproducibility and comparability of findings. We investigated a delta modified Sequential Organ Failure Assessment (delta mSOFA) score as a uniform composite clinical endpoint for use in clinical trials investigating therapeutics for moderate and severe dengue.MethodsWe developed a modified SOFA score for dengue, measured and evaluated its performance at baseline and 48 h after enrolment in a prospective observational cohort of 124 adults admitted to a tertiary referral hospital in Vietnam with dengue shock. The modified SOFA score included pulse pressure in the cardiovascular component. Binary logistic regression, cox proportional hazard and linear regression models were used to estimate association between mSOFA, delta mSOFA and clinical outcomes.ResultsThe analysis included 124 adults with dengue shock. 29 (23.4%) patients required ICU admission for organ support or due to persistent haemodynamic instability: 9/124 (7.3%) required mechanical ventilation, 8/124 (6.5%) required vasopressors, 6/124 (4.8%) required haemofiltration and 5/124 (4.0%) patients died. In univariate analyses, higher baseline and delta (48 h) mSOFA score for dengue were associated with admission to ICU, requirement for organ support and mortality, duration of ICU and hospital admission and IV fluid use.ConclusionsThe baseline and delta mSOFA scores for dengue performed well to discriminate patients with dengue shock by clinical outcomes, including duration of ICU and hospital admission, requirement for organ support and death. We plan to use delta mSOFA as the primary endpoint in an upcoming host-directed therapeutic trial and investigate the performance of this score in other phenotypes of severe dengue in adults and children.

Serum ferritin levels as an early prognostic marker in dengue fever

Dengue virus infection is showing upsurge with rapid urbanization and climate change in India. The spectrum of disease varies from mild illness to severe disease such as dengue hemorrhagic syndrome, dengue shock, multi-organ failure, and death therefore prompt recognition of severe form is crucial to improve the survival in severe dengue. Currently there are no tests available to predict the course of the illness therefore it is imperative to develop an early reliable and feasible biomarker to predict the severity of dengue illness which can aid in vigorous monitoring and early intervention. In this study we tried to establish a correlation between serum ferritin and severity of dengue illness and analyzed whether serum ferritin can be used to predict the severity at an earlier stage. Methods: This was a Cross sectional study conducted at tertiary care hospital. 350 patients above 18 years with fever of duration less than 2 weeks with thrombocytopenia were enrolled. Serum ferritin levels were measured and results were analyzed. Results: Out of 350 patients Dengue was diagnosed in 210 patients. Mean Ferritn levels were highest in dengue patients (2898.18±2097.72 μg/l) and Severe dengue patients had significantly higher median ferritin levels (3985 μg/l) compared to non-severe dengue group with median 1936 μg/l (p value <0.001). Conclusion: Serum ferritin can serve as a surrogate marker of dengue fever. Serum ferritin is an inexpensive and easily accessible biomarker that can be used as a prognostic marker to predict severity of disease.

Diffuse alveolar hemorrhage complicating dengue haemorrhagic fever in a 15-year-old boy: A case report

Rationale: Dengue fever is a viral infection that is spread through the bites of infected female Aedes mosquitos. It can cause life threatening complications, including dengue haemorrhagic fever (DHF) and dengue shock syndrome.Patient concerns: A 15-year-old male presented with fever and petechiae and later developed hemoptysis.Diagnosis: Dengue fever with DHF with diffuse alveolar hemorrhage.Interventions: Invasive ventilation with high positive end expiratory pressure, multiple transfusions of packed red blood cells, fresh frozen plasma, single donor platelets and inotropic supportOutcomes: The patient was stabilized and discharged on minimal supplemental oxygen.Lessons: Diffuse alveolar hemorrhage, although very rare, should be considered in a patient with dengue who presents with hemoptysis. The treatment is directed at providing respiratory and circulatory support, and preventing the progression of microcirculation damage.

Frequency of Capillary leak syndrome in Dengue fever Patients

Abstract
 Background: Dengue fever is the world’s fastest spreading mosquito borne viral infection. It is prevalent throughout both subtropical and tropical region if the world. The severe form of dengue fever with bleeding manifestations called as dengue hemorrhagic fever. Some of the Dengue fever patients developed capillary leak during critical period of illness. This study aims at determining the frequency of capillary leak syndrome in hospitalized dengue fever patients of tertiary care hospital.
 Patients and Methods: The study was conducted over a period of one month from 1st October to 30th October 2019 at department of Medicine Federal Government Polyclinic Post Graduate Medical Institute, Islamabad. This cross sectional study comprising 200 consecutive hospitalized (≥14 years of both gender) dengue fever patients.
 Results: Capillary leak syndrome found in 75 patients of Dengue fever. All of them were Primary Dengue Patients. Both ascites and effusion was present in 31 patients. Ascites only found in 25 patients, Pleural effusion bilateral in 7, Right sided pleural effusion in 11 and Left sided in 1 patient. None of the patient had pericardial effusion.
 Conclusion: It is concluded that capillary leak syndrome is common in primary dengue fever patients and its early diagnosis helps us in better management during critical phase of illness with better outcome.
 Key Words: Dengue Fever, Capillary Leak Syndrome, Dengue Shock

TO STUDY THE COMPLICATIONS IN DENGUE LIKE ILLNESSES IN CHILDREN

Background: Dengue has a wide spectrum of clinical presentations, often with unpredictable clinical evolution and outcome. To study the complication of dengue like illness in children
 Methods: The hospital based study was conducted on patients presenting to paediatric hospital, who fulfilled inclusion and exclusion criteria.
 Results: According to complications, in dengue positive cases, bleeding was the most common complication seen in 51.00% cases while shock, myocarditis, and convulsion were present in 34.00%, 3.00% and 1.00% of cases respectively.
 Conclusion: It concluded that dengue hemorrhagic shock was most common complication.
 Keywords: Dengue Like Illness, Complication, Shock.

Impact of Recent SARS-CoV-2 Infection on the Course and Severity of Dengue in Children: A Prospective Observational Study from North India.

ABSTRACT.In 2020, a considerable overlap occurred between the COVID-19 pandemic and seasonal dengue transmission in India. This study aimed to evaluate the effects of acute or recent infection with SARS-CoV-2 on the course and outcomes of dengue fever in children. We prospectively enrolled 44 children with a clinical and laboratory diagnosis of dengue fever. Assessment of acute and recent SARS-CoV-2 infection was done using reverse transcription–polymerase chain reaction and IgG antibody through ELISA. Children were grouped based on evidence of SARS-CoV-2 exposure and clinical severity, and outcomes were compared. The median age of the study cohort was 96 months (interquartile range [IQR]: 69–129 months). Fever (98%), vomiting (78%), abdominal pain (68%), hepatomegaly (68%), and edema (32%) were the common features. About two-thirds (N = 30) had severe dengue; 20 (45%) had dengue shock. Liver dysfunction (58%) and acute kidney injury (25%) were other major organ dysfunctions. Nineteen (43%) children stayed in the pediatric intensive care unit for a median duration of 5 days (IQR: 2–11 days). None had acute SARS-CoV2 infection; however, IgG against SARS-CoV-2 was detected in 15 (34%) cases. Children with recent exposure to SARS-CoV-2 showed a trend toward a lower incidence of acute kidney injury, fewer organ dysfunctions, and a lower frequency of invasive ventilation. Four children (9%) died; none of the deaths were in the SARS-CoV-2–exposed group. The present study exposes preliminary evidence that dengue fever might follow a less severe course in children with recent exposure to SARS-CoV-2 infection. However, it is pertinent to understand the antigenic similarity and cross-protective antibody response between the two viruses and their clinical relevance.

A prospective observational study on assessment of types of shock in children and requirement of inotropes in treatment of shock in tertiary care hospital

Background: Shock is a state of impaired tissue perfusion which result in an imbalance between oxygen demand and supply. This reduction in effective tissue perfusion causes insufficient or improper delivery and distribution of oxygen and nutrients. There is sparse date regarding epidemiology of shock in paediatrics. In this study we were aimed to assess the types of shock and treatment of shock with Inotropes.Methods: Children of age 1 month to 12 years with a clinical diagnosis of shock were included.Results: Out of 155 children admitted with shock 72.2% had septic shock, 25.8% had hypovolemic shock, 1.2% had cardiogenic shock, 0.6% had dengue shock. In this study the mortality rate was 8.39% of total patients. The mortality rate of septic shock, hypovolemic shock, cardiogenic shock was 84%, 7.69%, 7.69% respectively. 74.33% of patients were treated with two Inotropes, 5.3% were treated with more than two Inotropes, 11.5% were treated with single Inotropes and 0.88% was treated with no inotrope.Conclusions: In the present study, among all types of shock the prevalence and mortality rate was more with Septic shock. As shock has high mortality rate in children the early recognition and patient education is required.

Serum Ferritin As a Prognostic Indicator in Adult Dengue Patients.

Dengue virus (DENV) infection is increasing with rapid urbanization in India. Treatment of DENV infection is mainly supportive with no specific antiviral therapy. Although most patients show mild illness, some have a severe disease course such as dengue hemorrhagic syndrome, dengue shock, multi-organ failure, and death. The cause for severity is not fully understood. Currently, there are no methods available to predict the course of the illness. Hence, it is crucial to develop an early biomarker to predict the course of dengue illness which can aid in vigorous monitoring and early intervention. Here, we tried to establish a correlation between serum ferritin and severity of dengue illness. We measured ferritin levels in 100 dengue-positive cases on day 1 (D1) (febrile phase) and day 4 (D4) (defervescence or convalescent) of admissions to compare the levels with the severity of the disease. On D1, the serum ferritin level was a "good" predictor of severe dengue, with an area under the curve (AUC) of 0.863 with standard error (SE) = 0.043 and a 95% CI from 0.778 to 0.947 (P < 0.05). On D4, serum ferritin was an "excellent" predictor of severe dengue, with an AUC of 0.947 with SE = 0.021 and a 95% CI from 0.907 to 0.988 (P < 0.05). Serum ferritin is an inexpensive and easily accessible biomarker that can assist in monitoring and prognosticating the dengue-positive patients. This biomarker also directs us to explore the underlying pathogenetic mechanism in severe dengue, which can lay a foundation for future targeted therapeutic options to combat severe illness.

Microvascular dysfunction in septic and dengue shock: Pathophysiology and implications for clinical management

The microcirculation comprising of arterioles, capillaries and post-capillary venules is the terminal vascular network of the systemic circulation. Microvascular homeostasis, comprising of a balance between vasoconstriction, vasodilation and endothelial permeability in healthy states, regulates tissue perfusion. In severe infections, systemic inflammation occurs irrespective of the infecting microorganism(s), resulting in microcirculatory dysregulation and dysfunction, which impairs tissue perfusion and often precedes end-organ failure. The common hallmarks of microvascular dysfunction in both septic shock and dengue shock, are endothelial cell activation, glycocalyx degradation and plasma leak through a disrupted endothelial barrier. Microvascular tone is also impaired by a reduced bioavailability of nitric oxide. In vitro and in vivo studies have however demonstrated that the nature and extent of microvascular dysfunction as well as responses to volume expansion resuscitation differ in these two clinical syndromes. This review compares and contrasts the pathophysiology of microcirculatory dysfunction in septic versus dengue shock and the attendant effects of fluid administration during resuscitation.

Correlation of ultrasound measurement of IVC to aorta diameter ratio with hematocrit and shock severity among children with dengue fever

Background: Severe dengue is a leading cause of serious illness and death, particularly in the Philippines. There is no specific treatment for dengue fever. Before fluid resuscitation, a baseline hematocrit is obtained, and frequent monitoring of the complete blood count is needed depending on the case of the patient. Aside from obtaining the hematocrit, the IVC/Ao diameter ratio can be a promising tool in objectively guiding the clinicians during the fluid resuscitation in real-time. This study aims to determine the correlation of ultrasound measurement of IVC to aorta diameter ratio with hematocrit and severity of shock among children with dengue fever seen at the emergency room. Methods and materials: This is a prospective observational study design that was conducted at the ER of a tertiary hospital. Clinical data and hematocrit of the children with dengue fever aged 1 m to 18 y old were documented. The Inferior vena cava diameter (IVC)and the Aorta (Ao) diameter ratio was determined using bedside ultrasound. Results: The IVC/Ao diameter ratio correlates with high hematocrit and dengue shock in children (p < 0.0001). There is a significantly higher proportion of subjects with a hematocrit of normal range of age among those with a ratio 1.0. A ratio of <0.8 is significantly associated with high hematocrit level for age (p < 0.0001). Overall, IVC/Ao diameter ratio was significantly associated with severity of Dengue illness. 97% of those without warning signs had IVC/Ao diameter ratio of 1.00 (p < 0.0001). For those with warning signs, 63.4% had a ratio of from 0.8–0.99, and 93% with severe dengue had a ratio of from <0.80 (p < 0.0001). Sensitivity or the probability of identifying those with true disease, of IVC/Ao diameter ratio of <1.00 in predicting dengue with warning signs and severe dengue (grouped) was 87.7%. Specificity or the probability of identifying those without the disease (without warning signs) was higher at 97.1%. Measurement of IVC/Ao diameter ratio has high interrater and intrarater reliability. Conclusion: This study concludes that the IVC/Ao ratio correlates with the severity of dengue fever and with the hematocrit in the emergency setting. Overall, IVC/Ao diameter ratio was significantly associated with severity of dengue illness.

The Utility of Platelet Indices in Predicting Multiorgan Dysfunction in Scrub Typhus.

Platelet indices have been used to diagnose and prognosticate infections such as tuberculosis, malaria, dengue, and septic shock. Platelet indices have previously not been used in the prediction of multiorgan dysfunction (MODS) in patients with scrub typhus. A three-year retrospective review of patient charts was performed. Patients with and without MODS were compared. Platelet indices and other clinical and laboratory variables were used in logistic regression analysis to determine significant predictors. A ROC curve was generated with the platelet indices to predict MODS. Of 189 patients, 106 were male. Respiratory rate, serum creatinine, liver function tests, platelet count, thrombocytopenia <150 × 109/L, mean platelet volume (MPV) > 7.3 fL, and plateletcrit ≤0.19% varied significantly between patients with MODS and those without. Platelet indices are inexpensive and easily available. Only thrombocytopenia along with creatinine, alanine transaminase, and abnormal chest radiograph could significantly predict MODS in patients with scrub typhus.

Maternal and Neonatal Outcomes during Dengue Infection Outbreak at a Tertiary National Hospital in Endemic Area of Indonesia.

BackgroundDengue infection is the most common mosquito-borne disease in Indonesia. Dengue incidence during pregnancy increases with its prevalence among women of reproductive ages. It potentially causes serious maternal and neonatal morbidity and mortality; however, its impact during a period of disease outbreak has not been described. We aimed to assess the outcomes of pregnancies affected by dengue infection during an outbreak in an endemic area of Indonesia.MethodsWe conducted a prospective observational study at Sanglah General Hospital, Bali, Indonesia from April 2016 to April 2017. All pregnant women with clinical symptoms of dengue infection who tested positive for dengue nonstructural protein 1-antigen or anti-dengue immunoglobulin M were included in the study. Clinical features and hematological and biochemical parameters were documented to assess their relationship with maternal and neonatal outcomes.ResultsOur study population consisted of 41 pregnant women. Most were multigravida (58.5%). Dengue infection without warning signs was observed in 31.7% of the cases, while 53.7% had dengue infection with warning signs, and 14.6% had dengue shock syndrome/severe dengue infection. Most pregnancies were in the third trimester (78%); five cases (12.2%) suffered clinical complications. Preterm delivery was observed in seven cases (17.1%). Most patients (75.6%) decided to seek medical treatment at a critical phase of dengue infection (days 3–6).ConclusionThe high incidence of associated morbidity and mortality should warrant clinicians in endemic regions to consider diagnoses of dengue infection when treating pregnant women with clinical signs and symptoms. Patients should be treated at centers with adequate resources for monitoring and emergency procedures. A more intensive study is needed in the future aiming to make a more comprehensive guideline.

Pakistani media and the rising fear of dengue fever.

Objectives: In this study we analyze how much the general population fear from dengue fever based on their knowledge acquired via media. Study Design: Cross-sectional study. Setting: Civil Hospital, Karachi, Pakistan. Period: 1st August 2019 to 30th September 2019. Material &amp; Method: Non-Probability consecutive sample technique was used. Patients with dengue fever were asked to fill a questionnaire which comprised of demographic variables as well as questions regarding their fear of dengue fever based on their information acquired from media particularly news channels. Results: Out of 2750 patients who underwent dengue serology, 727 came positive for active dengue viral infection. Of them 204 patients required admission. Patients were asked to rate how much they think dengue fever is lethal. The mean of all responses was 7.8 (p&lt;0.005). When asked about the route of transmission 93% answered the correct mode of transmission. 59.4% (n=432) think that dengue fever requires anti-biotics while 40.5% (n=295) knew that the management of dengue fever is supportive. We asked the study subjects about what did they know about dengue hemmorhagic fever and dengue shock. Of the 727 individuals, 10.3% (n=75) knew regarding any of them. 89.6% had no idea. Conclusion: We hereby conclude that although media has done a great job in educating the people, it has also created a fear among the general population regarding dengue fever which the clinicians face every day.

Catastrophic health care expenditure due to septic shock and dengue shock in Vietnam.

BackgroundThe cost of treatment for infectious shock in intensive care in Vietnam is unknown.MethodsWe prospectively investigated hospital bills for adults treated for septic and dengue shock in Vietnam and calculated the proportion who faced catastrophic health care expenditures.ResultsThe median hospital bills were US$617 for septic shock (n=100) and US$57 for dengue shock (n=88). Catastrophic payments were incurred by 47% (47/100) and 13% (11/88) of patients with septic shock and dengue shock, respectively, and 56% (25/45) and 84% (5/6) fatal cases of septic shock and dengue shock respectively.ConclusionsFurther advocacy is required to moderate insurance co-payments for costly critical care interventions.

A Study on Indication for Mechanical Ventilation among Children at a Tertiary Care Hospital

Background: Currently, pneumonia is the sixth leading cause of death in the United States and the leading cause of death of children worldwide. The mortality rate for patients of all ages with VAP is approximately 33% to 50%.Approximately 10-28% of critical care patients develop Ventilator Associated Pneumonia (VAP). It increases length of stay in ICU up to 28% and each incidence of Ventilator-associated pneumonia (VAP) is estimated to generate an increased cost of £6000-£22000. Mortality rate is 24%-71%. Subjects and Methods: All patients on mechanical ventilator admitted to the pediatric intensive care unit during the prescribed study period were considered for case identification and study was prospective study. Results: Most common diagnosis at presentation in patients studied was Severe dengue 50(33.3%), followed by Pneumonia 25(16.7%), Sepsis 14(9.3%). Conclusion: Most common indication for mechanical ventilation in patients studied was Severe respiratory distress (33.3%), followed by septic shock (20%), poor GCS (18.7%), Dengue shock (16.7%).

Clinical Characteristic and Risk Factors of Acute Kidney Injury among Dengue Viral Infections in Adults: A Retrospective Analysis.

Dengue is a growing public health problem in India, and acute kidney injury (AKI) is one of the least studied complications of dengue virus infection (DVI). This study was conducted to investigate the incidence, clinical characteristics, and risk factors for AKI in DVI. This was a retrospective study of patients with confirmed DVI presenting as dengue fever (DF) or dengue hemorrhagic fever/dengue shock syndrome (DHF/DSS) at our center over a period of 2 years. A total of 620 subjects fulfilling inclusion criteria were studied. Patients were divided into two cohorts (90 patients with AKI and 530 patients without AKI) to determine independent predictors of AKI. Among 620 patients, 454 (73.22%) had classical DF, 141 (22.74%) patients had DHF, and 25 (4.03%) patients had DSS. AKI was present in 90 (16.36%) patients; approximately one-third (31, 34.45%) had AKIN stage 1, 33 (36.66%) patients had AKIN stage 2, and 26 (28.88%) had AKIN stage 3. Among those with AKI, 14 patients expired and all had DHF/DSS. On multivariate logistic regression, AKI was associated with male gender [odds ratio (OR): 2.9], DHF (OR: 7.9), rhabdomyolysis (OR: 8.2), multiple-organ dysfunction (OR: 18.2), hypertension (OR: 0.7), diabetes mellitus (OR: 4.8), delayed hospitalization (OR: 2.2), and use of nephrotoxic drugs (OR: 2.86). In all, 320 patients (51.61%) had hospital stay >3 days. We found that AKI was an independent predictor for longer duration of hospital stay (OR: 7.2, 95% confidence interval: 4.8–10.7). AKI in DVI is associated with significant morbidity, mortality and longer hospital stay.