Anesthetic management of a 17-month-old patient with severe dengue fever, anemia, ascites, and secondary acinetobacter baumannii infection: A case report

Dengue fever, especially in its severe forms such as dengue hemorrhagic fever (DHF) and dengue shock syndrome (DSS), is a significant global health concern. This case report discusses the anesthetic management of a 17-month-old male with severe dengue complicated by profound anemia, ascites, and a secondary infection with Acinetobacter baumannii. The child presented with tachycardia, tachypnea, severe thrombocytopenia, and hepatomegaly. His critical condition required a multidisciplinary approach to ensure optimal care and a favorable outcome. Preoperative assessment highlighted the need for addressing hematological abnormalities and fluid imbalances. Thrombocytopenia was severe enough to necessitate platelet transfusions. Anemia was addressed by red blood cell transfusions. Fluid balance was hard to maintain because of ascites and the danger of fluid overload. Monitoring and adjustments had to be very meticulous. Secondary bacterial infection was addressed by specific antibiotics, which were begun early. Since the child was critically in need of surgical intervention, general anesthesia was administered for escharotomy. Invasive monitoring with arterial and central venous catheters allowed for continuous assessment of hemodynamics, fluid status, and oxygenation. Collaboration between the anesthesiology team and the PICU staff during the perioperative period was also very crucial. The child was managed postoperatively in the PICU, with close monitoring of the vital signs, respiratory functions, and fluid-electrolyte balance. A multidisciplinary effort ensured substantial clinical improvement, with proof of the value of the teamwork-based approach. Specialized anesthetic management and interdepartmental collaboration in the care of complex pediatric patients are crucial factors to achieve safety and promote recovery among the most vulnerable populations.