Perinatal dengue in a neonate with multiple comorbidities: case report and literature review.

Background: Dengue is an increasingly common arboviral infection in endemic regions and can affect pregnant women. Neonatal presentations are uncommon and often overlap with other perinatal conditions such as meconium-related lung disease and early-onset bacterial infection, complicating diagnosis and management. Case presentation: We report a term male neonate born through meconium-stained amniotic fluid to a mother with late-pregnancy dengue. Within hours, the infant developed tachypnea and coarse rales. Initial studies showed metabolic acidosis and coagulopathy; chest radiography demonstrated bilateral patchy opacities. A working diagnosis of meconium aspiration syndrome was made, and empiric penicillin, oxygen, and supportive care were initiated. On day 2, dengue NS1 antigen tested positive; Respiratory PCR detected low-level Conclusions: Neonatal dengue should be considered in infants born to mothers with recent dengue in endemic settings. A structured approach-early supportive care, targeted testing (NS1/RT-PCR/serology), careful interpretation of neonatal coagulation and platelet trends, and judicious antimicrobial use-can aid differentiation from overlapping perinatal lung disease and guide timely management.