Background Staphylococcus aureus co-infection is seldom reported in children with severe dengue. Methodology In this retrospective study, we reported five children with severe dengue and S. aureus co-infection admitted to pediatric intensive care unit (PICU) during July–December 2021. Results All children had prolonged fever, persistence of bilateral pleural effusion beyond the critical phase, thrombocytopenia and raised inflammatory markers [C-reactive protein (CRP) and procalcitonin]. S. aureus was isolated from pleural fluid (n = 2, 40%), blood (n = 2, 40%) and endotracheal aspirate (n = 1, 20%). Four children (80%) grew methicillin-sensitive S. aureus, while 1 (20%) had methicillin-resistant S. aureus. Two children (40%) had septic thromboemboli in skin, and 1 (20%) had limb cellulitis. One child required anterior thoracotomy, pericardiectomy and bilateral pleural decortication, while all other children required intercostal chest tube drainage. All children required prolonged targeted antibiotics, invasive mechanical ventilation and had prolong stay in PICU and all of them survived. Conclusion In children with severe dengue, persistence of fever, persistence of pleural effusion beyond critical phase and raised CRP and procalcitonin should raise suspicion of bacterial/S. aureus co-infection.

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儿科患者与金黄色葡萄球菌败血症相关的严重登革热：病例系列

背景 金黄色葡萄球菌合并感染在重症登革热患儿中很少见报道。方法 在这项回顾性研究中，我们报告了 2021 年 7 月至 12 月期间入住儿科重症监护病房 (PICU) 的 5 名重度登革热和金黄色葡萄球菌合并感染儿童。结果 所有儿童均出现长时间发热、持续双侧胸腔积液超过临界值相、血小板减少和炎症标志物 [C 反应蛋白 (CRP) 和降钙素原] 升高。从胸腔积液 (n = 2, 40%)、血液 (n = 2, 40%) 和气管内抽吸物 (n = 1, 20%) 中分离出金黄色葡萄球菌。4 名儿童 (80%) 长出了对甲氧西林敏感的金黄色葡萄球菌，而 1 名 (20%) 长出了耐甲氧西林金黄色葡萄球菌。2 名儿童 (40%) 有皮肤脓毒性血栓栓塞，1 名 (20%) 有肢体蜂窝组织炎。一名儿童需要前路开胸手术，心包切除术和双侧胸膜剥脱术，而所有其他儿童都需要肋间胸管引流。所有患儿都需要长期靶向抗生素、有创机械通气，并在 PICU 停留时间较长，但均存活下来。结论 重症登革热患儿持续发热、持续超过临界期的胸腔积液以及CRP和降钙素原升高应怀疑细菌/S。金黄色葡萄球菌合并感染。如果胸腔积液持续超过临界期且 CRP 和降钙素原升高，应怀疑细菌/S。金黄色葡萄球菌合并感染。如果胸腔积液持续超过临界期且 CRP 和降钙素原升高，应怀疑细菌/S。金黄色葡萄球菌合并感染。