<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>1012-2966</journal-id>
<journal-title><![CDATA[Gaceta Médica Boliviana]]></journal-title>
<abbrev-journal-title><![CDATA[Gac Med Bol]]></abbrev-journal-title>
<issn>1012-2966</issn>
<publisher>
<publisher-name><![CDATA[Facultad de Medicina de la Universidad Mayor de San Simón]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S1012-29662025000100166</article-id>
<article-id pub-id-type="doi">10.47993/gmb.v48i1.922</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Asma severo y dengue en paciente crítico. Reporte de un caso en la Unidad de Cuidados Intensivos]]></article-title>
<article-title xml:lang="en"><![CDATA[Severe asthma and dengue fever in a critically ill patient. Case report from the Intensive Care Unit.]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Coaguila-Cusicanqui]]></surname>
<given-names><![CDATA[Luis Angel]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
<xref ref-type="aff" rid="Aaf"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Zeña Muñoz]]></surname>
<given-names><![CDATA[Miriam Elízabeth]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Rodas Iberico]]></surname>
<given-names><![CDATA[Marcia Daniela]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Aguilar-Gamboa]]></surname>
<given-names><![CDATA[Franklin Rómulo]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Hospital Regional Lambayeque Unidad De Cuidados Intensivos ]]></institution>
<addr-line><![CDATA[Chiclayo ]]></addr-line>
<country>Perú</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,Universidad de San Martín de Porres Facultad de Medicina humana ]]></institution>
<addr-line><![CDATA[Chiclayo ]]></addr-line>
<country>Peru</country>
</aff>
<aff id="Af3">
<institution><![CDATA[,Hospital Regional Lambayeque Laboratorio de virología e inmunología, dirección de investigación ]]></institution>
<addr-line><![CDATA[Chiclayo ]]></addr-line>
<country>Perú</country>
</aff>
<aff id="Af4">
<institution><![CDATA[,Universidad Señor de Sipán Facultad de Ciencias de la Salud Escuela de Medicina Humana]]></institution>
<addr-line><![CDATA[Chiclayo ]]></addr-line>
<country>Peru</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>00</month>
<year>2025</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>00</month>
<year>2025</year>
</pub-date>
<volume>48</volume>
<numero>1</numero>
<fpage>166</fpage>
<lpage>170</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://www.scielo.org.bo/scielo.php?script=sci_arttext&amp;pid=S1012-29662025000100166&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.bo/scielo.php?script=sci_abstract&amp;pid=S1012-29662025000100166&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.bo/scielo.php?script=sci_pdf&amp;pid=S1012-29662025000100166&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[Resumen Este estudio de caso presenta el manejo clínico de una paciente de 17 años con múltiples comorbilidades, que incluyeron dengue con signos de alarma, neumonía adquirida en la comunidad, insuficiencia respiratoria y antecedentes de asma severa. El caso se desarrolló en junio de 2024, en el contexto de un significativo brote de dengue que azotó Perú desde 2023.La paciente, procedente de Chiclayo, fue ingresada en la Unidad de Cuidados Intensivos (UCI) del Hospital Regional de Lambayeque con insuficiencia respiratoria. Las pruebas serológicas confirmaron una reinfección por dengue, lo que planteaba la posibilidad de un fenómeno de Amplificación Dependiente de Anticuerpos (ADE). La tomografía computarizada de tórax reveló la presencia de opacidades en vidrio esmerilado en los lóbulos pulmonares, hallazgos compatibles con neumonía viral. Durante su estancia en la UCI, se implementó un monitoreo integral de las funciones respiratorias y hepáticas, brindando soporte oxigenatorio y observando una disminución progresiva seguida de recuperación de las plaquetas. La paciente presentaba un compromiso respiratorio significativo, requiriendo ventilación mecánica no invasiva y posteriormente, oxígeno suplementario a alto flujo. El manejo clínico incluyó tratamiento sintomático y monitoreo hemodinámico constante. Este caso ilustra la complejidad que entraña el abordaje de pacientes con múltiples comorbilidades en el contexto de una infección por dengue. Destaca la importancia de un enfoque integral en el diagnóstico y tratamiento, así como la necesidad de considerar las posibles complicaciones respiratorias asociadas a enfermedades virales como el dengue, especialmente en pacientes con antecedentes de afecciones respiratorias como el asma severa.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract This case study presents the clinical management of a 17-year-old patient with multiple comorbidities, including dengue with warning signs, community-acquired pneumonia, respiratory failure, and a history of severe asthma. The case occurred in early 2024, in the context of a significant dengue outbreak that has affected Peru since 2023. The patient, from Chiclayo, was admitted to the Intensive Care Unit (ICU) of the Regional Hospital of Lambayeque with respiratory failure. Serological tests confirmed a dengue reinfection, raising the possibility of Antibody- Dependent Enhancement (ADE) phenomenon. The chest CT scan revealed the presence of ground-glass opacities in the lung lobes, findings compatible with viral pneumonia. During her stay in the ICU, comprehensive monitoring of the respiratory and hepatic functions was implemented, providing oxygenation support and observing a progressive decrease followed by recovery of platelets. The patient had significant respiratory compromise, requiring non-invasive mechanical ventilation and subsequently, high-flow supplemental oxygen. Clinical management included symptomatic treatment and constant hemodynamic monitoring. This case illustrates the complexity of managing patients with multiple comorbidities associated with dengue infection. It highlights the importance of a comprehensive approach in diagnosis and treatment, as well as the need to consider possible respiratory complications associated with viral diseases like dengue, especially in patients with a history of respiratory conditions such as severe asthma.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[Dengue]]></kwd>
<kwd lng="es"><![CDATA[insuficiencia respiratoria]]></kwd>
<kwd lng="es"><![CDATA[comorbilidades]]></kwd>
<kwd lng="es"><![CDATA[neumonía viral]]></kwd>
<kwd lng="es"><![CDATA[Amplificación Dependiente de Anticuerpos (ADE)]]></kwd>
<kwd lng="en"><![CDATA[Dengue]]></kwd>
<kwd lng="en"><![CDATA[Respiratory failure]]></kwd>
<kwd lng="en"><![CDATA[Comorbidities]]></kwd>
<kwd lng="en"><![CDATA[Viral pneumonia]]></kwd>
<kwd lng="en"><![CDATA[Antibody-Dependent Enhancement (ADE)]]></kwd>
</kwd-group>
</article-meta>
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