Sudden Infant Death in an 8-Month Old Baby with Dengue Virus Infection: Searching for Virus in Post-Mortem Tissues by Immunohistochemistry and Western Blotting.

Dengue causes a severe flu-like illness, and sometimes a poten- tially lethal form called dengue hemorrhagic fever (DHF), which is characterized by high fever, often with enlargement of the liver and in severe cases, circulatory failure. When dengue infec- tions proceed to DHF symptoms, DHF causes vascular leak syn- drome in which fluid in the blood vessels leaks through the skin and into spaces around the lungs and abdomen. This fluid loss and severe bleeding can cause blood pressure to fall, then causing den- gue shock syndrome, which has a high risk of death. Each year, dengue infections result in ~25,000 deaths, primarily in children. The dengue virus (DENV) genome is infectious and consists of a single-stranded, positive-sense RNA with an approximate size of 11 kb. The molecular weight of DENV is 61 kDa. Currently, labo- ratory diagnosis of dengue infection is based on virus isolation in mosquito cell cultures and on detection of viral RNA and DENV- specific antibodies in either serum or plasma.1 Serologic diagnosis of dengue in tissues specimens is also achieved by experienced per- sonnel in immunohistochemistry. These techniques have allowed the detection of DENV in liver, spleen, brain, lungs, lymph nodes, thymus, kidney, heart, bone marrow and skin.2,3 We aimed to assess the usefulness of DENV antigens as a postmortem diagnostic technique to demonstrate the viral presence in human tissue specimens by immunohistochemistry and Western blotting in the case of the sudden death of an 8-month-old baby.