Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 Apr 1;65(4):235-241.
doi: 10.11622/smedj.2021167. Epub 2021 Nov 8.

Dengue virus infection among renal transplant recipients in Singapore: a 15-year, single-centre retrospective review

Sophie Seine Xuan Tan  1 , Quan Yao Ho  2 , Sobhana Thangaraju  2 , Thuan Tong Tan  1 , Terence Kee  2 , Shimin Jasmine Chung  1
Affiliations

Dengue virus infection among renal transplant recipients in Singapore: a 15-year, single-centre retrospective review

Sophie Seine Xuan Tan et al. Singapore Med J. .

Abstract

Introduction: Dengue is a mosquito-borne viral infection endemic in Singapore. Its impact on renal transplantation is limited to small case series. We aimed to characterise the clinical presentation and outcomes of dengue infection among renal transplant recipients in Singapore.

Methods: We conducted a 15-year retrospective review of dengue in renal transplant patients treated at Singapore General Hospital between January 2005 and October 2019. The diagnosis of dengue was made if there were a compatible clinical syndrome and a positive dengue diagnostic assay (dengue non-structural 1 antigen, immunoglobulin M or reverse transcriptase-polymerase chain reaction).

Results: Of the 31 patients diagnosed with dengue, 18 (58.1%) were deceased donor recipients. The median age was 52 (interquartile range [IQR] 40-61) years; 16 (51.6%) were females. The median time to diagnosis was 99 (IQR 18-169) months from transplant. The most common clinical symptoms were fever (87.1%), myalgia (41.9%), gastrointestinal symptoms (38.7%) and headache (25.8%). Nineteen (61.3%) patients had dengue without warning signs, nine (29.0%) had dengue with warning signs, three (9.7%) had severe dengue and 30 (96.8%) were hospitalised. Seventeen (54.8%) patients had graft dysfunction, 16 (94.1%) of whom had recovery of graft function. One (3.2%) patient required dialysis and subsequently died. There were two cases of donor-derived infections (DDIs) with favourable outcomes.

Conclusion: Our experience with dengue in renal transplant recipients is concordant with published data. Although graft dysfunction is common, it is often transient with favourable outcomes. Outpatient management may be considered for mild infections. Although dengue DDIs are uncommon, more stringent donor screening may be considered in endemic regions.

PubMed Disclaimer

Conflict of interest statement

There are no conflicts of interest.

Figures

Figure 1
Figure 1
Graph shows the dengue trend in Singapore[9] and among renal transplant patients from 2005 to 2019.
See this image and copyright information in PMC

References

    1. World Health Organization. Dengue guidelines for diagnosis, treatment, prevention and control: New edition. 2009. [[Last accessed on 2020 Dec 20]]. Available from: https://apps.who.int/iris/bitstream/handle/10665/44188/9789241547871_eng... . - PubMed
    1. Rigau-Pérez JG, Clark GG, Gubler DJ, Reiter P, Sanders EJ, Vorndam AV. Dengue and dengue haemorrhagic fever. Lancet. 1998;352:971–7. - PubMed
    1. Lee KS, Lai YL, Lo S, Barkham T, Aw P, Ooi PL, et al. Dengue virus surveillance for early warning, Singapore. Emerg Infect Dis. 2010;16:847–9. - PMC - PubMed
    1. National Environment Agency, Singapore. Dengue surveillance data, Oct-Dec 2020. [[Last accessed on 2021 Feb 24]]. Available from: https://www.nea.gov.sg/docs/default-source/default-document-library/q4-2... .
    1. Pinsai S, Kiertiburanakul S, Watcharananan SP, Kantachuvessiri S, Boongird S, Bruminhent J. Epidemiology and outcomes of dengue in kidney transplant recipients: A 20-year retrospective analysis and comparative literature review. Clin Transplant. 2019;33:e13458. - PubMed