Objective The burden of dengue fever (DF) is increasing rapidly worldwide. Several atypical manifestations of DF are being increasingly reported but there are no clear guidelines on their definition and management. Their timely detection and appropriate management might improve outcomes. We describe here our experience in managing atypical manifestations of DF in children and their outcomes in a teaching hospital in South India.

Methods A retrospective chart review of children (1 month–18 years) hospitalized, between August 2017 and March 2018 with a diagnosis of DF (NS1 antigen or immunoglobulin M antibodies positivity), was done. The clinical details of the atypical manifestations are described.

Results During the study period, 925 children were hospitalized with DF, of which 94 (10.16%) had severe dengue and 2 (0.21%) died. Among the 925 children, 7 (0.75%) had cardiac, 5 (0.54%) had neurological, 5 (0.54%) had hepatic, and 31 (3.3%) had immunological (infection-associated immune dysregulation) manifestations.

Conclusion Most children with atypical manifestations of DF recover with supportive management. There is a need for a clear definition of atypical manifestations so that large prospective multicenter studies on incidence, optimum management, and outcomes can be done.

目的 登革热的负担在世界范围内正在迅速增加。DF的几种非典型表现正在得到越来越多的报道，但是关于其定义和管理尚无明确的指南。及时发现和适当管理可能会改善结果。我们在这里描述了我们在南印度的一家教学医院处理儿童DF的非典型表现及其结果的经验。

方法 对2017年8月至2018年3月住院诊断为DF（NS1抗原或免疫球蛋白M抗体阳性）的儿童（1个月至18岁）进行回顾性图表回顾。描述了非典型表现的临床细节。

结果 在研究期间，有925名DF患儿住院，其中94例（10.16％）重症登革热，2例（0.21％）死亡。在925名儿童中，有7名（0.75％）有心脏疾病，有5名（0.54％）有心脏疾病，有5名（0.54％）有肝脏疾病，有31名（3.3％）有免疫性（感染相关的免疫失调）表现。

结论 大多数患有DF的非典型表现的儿童在支持治疗下得以康复。需要对非典型表现进行清晰的定义，以便可以对发病率，最佳治疗和结果进行大型的前瞻性多中心研究。