Objective: Dengue is an arboviral disease, spreads by female aedes mosquito, which has hepatotoxic effects on multiple organ systems. Cytokine extracorporeal hemoadsorption (Cytosorb^®) is considered to be a successful adjunctive therapy for adult patients to reduce bilirubin and toxic metabolites.

Patients and Methods: Here we present a case of a 10-year-old, Indian male patient who was admitted to our hospital with dengue haemorrhagic fever and associated Systemic inflammatory response syndrome (SIRS), acute fulminant hepatic failure with encephalopathy and oliguria. Post hepatoprotective strategies, over a 36 hour period an increase was observed in hepatic parameters with Serum glutamic oxaloacetic transaminase (SGOT)- 11,391(IU/L), Serum glutamic pyruvic transaminase (SGPT)- 4,572 (IU/L), platelets- 17,000 (/μL) and total bilirubin of 7.2 mg/dl: 5.1 mg/dL and 2.1 mg/dL of direct and indirect, respectively. In view of the Multi Organ Dysfunction Syndrome (MODS) adjunctive therapy with Cytosorb^® was initiated.

Results: After an 18 hour procedure, his liver function tests (LFTs) improved with SGOT-8,003 (IU/L), SGPT-3,573 (IU/L); total bilirubin-4.8 mg/dl and platelet count remarkably increased to 108000 (/μL). LFTs decreased and normalized values were attained over 5 days. The patient was extubated on day 9 of admission and was later discharged in an active, afebrile and hemodynamically stable condition.

Conclusions: Cytosorb^® along with standard care, can be a safe and advantageous extracorporeal therapy option to treat paediatric dengue patients with MODS.