An unusual cause for shock in dengue fever

Liyanage, Asd; Kumara, M T G J; Rupasinghe, Dhanushi; Sutharshan, S; Gamage, Bawantha; Kulathunga, A; Silva, W M M de

doi:10.4038/cmj.v56i3.3605

Cited by 4 publications

(14 citation statements)

References 4 publications

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“…U/S was used in three cases with limited findings, as ascites and splenomegaly . Needle paracentesis was further used to diagnose internal bleeding in four patients including three patients with CT scan, one case with U/S, and one case as a single investigation . Four patients were diagnosed with exploratory laparotomy …”

Section: Resultsmentioning

confidence: 99%

“…The histopathological examination of removed spleen from three patients through splenectomy showed pathological features . The changes include tissue rupture capsule, congested red pulp with extensive hemorrhagic and necrotic areas.…”

Section: Resultsmentioning

confidence: 99%

“…The changes include tissue rupture capsule, congested red pulp with extensive hemorrhagic and necrotic areas. In another case, the capsule was torn, while the parenchymal tissue was in normal structure …”

Section: Resultsmentioning

confidence: 99%

“…Immediate splenectomy after exploration was done for 12 patients (70.6%) . Conservative treatment was used in five cases .…”

Section: Resultsmentioning

confidence: 99%

“…Also, thrombocytopenia or coagulopathy in nonrapid compensatory extension may induce hematoma‐related rupture in normal‐sized spleen. This can be a potential cause in normal‐sized ruptured spleen in these cases . The mechanism of etiology in dengue infection is still vague.…”

Section: Discussionmentioning

confidence: 99%

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Systematic review of spontaneous splenic rupture in dengue‐infected patients

Radwan

Khattab

Mahmoud

et al. 2019

Reviews in Medical Virology

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Summary Dengue infection varies from a mild febrile form to more severe disease with plasma leakage, shock, and multiorgan failure. Several serious complications such as cardiomyopathy, encephalopathy, encephalitis, hepatic damage, and neural manifestations cause organ damage in dengue infection. Splenic rupture, a less well known but life‐threatening complication, can occur in dengue. The mechanism of splenic rupture in dengue is still unclear. Optimal therapeutic management is required to save the lives of patients with this complication. The objective of this study was to conduct a systematic review of studies documenting the development of spontaneous nontraumatic splenic rupture in patients with dengue infection. In March 2018, a search was conducted systematically in nine electronic databases, in addition to hand‐ searching. A total of 127 references were exported to Endnote; 47 references remained after removing duplicates. Finally, 16 reports met the inclusion criteria and represented 17 cases. All articles were evaluated and data extracted according to predefined criteria: number of cases, age, sex, severity of dengue disease, days of illness before admission, methods of definitive diagnosis, timing of the event, and management and outcome. A total of 17 individual patients including 13 males and four females were found. Most of the patients were young adults (ranging from 20 to 52 years) and diagnosed with computed tomography scan and managed with splenectomy. Four cases were fatal. Pathological splenic rupture in dengue is a rare, life‐threatening condition where timely management can achieve a favorable outcome.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

“…Immediate splenectomy after exploration was done for 12 patients (70.6%) . Conservative treatment was used in five cases .…”

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Systematic review of spontaneous splenic rupture in dengue‐infected patients

Radwan

Khattab

Mahmoud

et al. 2019

Reviews in Medical Virology

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Spontaneous splenic rupture during the recovery phase of dengue fever

Silva¹,

Gunasekera²

2015

BMC Res Notes

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BackgroundSpontaneous splenic rupture is a rare but known complication of dengue fever. Previously reported cases have occurred early during the course of the disease and most cases have led to a fatal outcome. Here we report a case of spontaneous splenic rupture in a patient with dengue fever, which occurred during the recovery phase of the illness.Case presentationA 28-year-old Sinhalese, Sri Lankan man presented with a history of fever, myalgia and vomiting of 4 days duration. Investigations revealed a diagnosis of dengue fever with no signs of plasma leakage. He was managed in the ward as per local protocol. During the recovery phase the patient developed severe abdominal distention with circulatory failure. Radiology revealed splenic rupture with massive amounts of abdominal free fluid. The patient was resuscitated and Emergency laparotomy with splenectomy was performed. The outcome was excellent with the patient making a complete recovery.ConclusionAlthough splenic rupture is a known complication of dengue fever it may be manifested late in the disease process. A high degree of suspicion should be maintained and patients must be monitored even during the recovery phase of dengue fever. Early diagnosis and intervention can prevent mortality.Electronic supplementary materialThe online version of this article (doi:10.1186/s13104-015-1234-5) contains supplementary material, which is available to authorized users.

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Spontaneous Splenic Rupture in Severe Dengue

Anam

Polash

Islam

et al. 2013

Bangladesh Crit Care J

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Dengue is a mosquito-borne systemic viral infection with variety of clinical presentation, ranging from mild febrile illness to severe and fatal disease. A patient presented with history of fever and abdominal pain, and later developed shock. From clinical and epidemiological features, he was diagnosed as a patient of severe dengue, later confirmed by laboratory investigations. In dengue, shock can result from plasma leakage, and abdominal pain may be a feature of acalculous cholecystitis or pancreatitis, recognised presentations of dengue and usually managed conservatively. But high index of suspicion persuaded abdominal imaging, revealing a potentially fatal complication of dengue- spontaneous splenic rupture. Aggressive resuscitation and early surgery saved the patient. DOI: http://dx.doi.org/10.3329/bccj.v1i1.14373 Bangladesh Crit Care J March 2013; 1: 59-62

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An unusual cause for shock in dengue fever

Cited by 4 publications

References 4 publications

Systematic review of spontaneous splenic rupture in dengue‐infected patients

Systematic review of spontaneous splenic rupture in dengue‐infected patients

Spontaneous splenic rupture during the recovery phase of dengue fever

Spontaneous Splenic Rupture in Severe Dengue

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