Dengue fever may mislead the surgeons when it presents as an acute abdomen

Abstract

DF/DHF misleads the clinicians when it presents as AA. Initial hematological and ultrasonographic findings may be equivocal creating a diagnostic and management dilemma. Vigilant clinical suspicion and early dengue serological assessment is advisable in equivocal cases of AAs with fever in dengue endemic areas, to confirm/exclude the infection in order to avoid unnecessary surgical morbidity in the presence of DF.

Acute acalculous cholecystitis in a pediatric dengue hemorrhagic fever patient: A case report, lesson learned from limited resource setting

“…The acalculous cholecystitis in DF/DHF is challenging in diagnosis due to atypical presentations, causes lack of detection and late diagnosis in severe condition. Sharp clinical suspicion and early dengue serological assessment are recommended in questionable cases of AAC with fever in dengue-endemic areas to confirm the infection, so unnecessary surgical morbidity due to the presence of DF can be avoided [ 13 ]. Initial hematological laboratory result which is inconjunct with abdominal ultrasonography findings can help physicians to consider this diagnosis [ 14 ].…”

“…Computerized tomography (CT) is considered as accurate as ultrasonography in diagnosing AAC. However, its radiological exposure restricts its use in the pediatric age and CT is not always available, more expensive and cannot be performed bedside [ 13 ]. Ultrasonography findings and laboratory parameters could not identify the causative agent of AAC.…”

Chest and Abdomen Ct Findings in Dengue Haemorrhagic Fever

“…Abdominal CT may help to clarify decision making in patients with DHF who present in this manner and may help prevent unnecessary laparotomy, which can lead to catastrophic consequences in the form of prolonged hospitalisations and need for repeated transfusion of blood products. 12 The most common finding on abdomen CT is ascites. Ascitic volume has been described 13 as minimal, mild, moderate, severe and massive, by looking for the presence of fluid in five areas of the abdomen, namely RUQ (perihepatic and Morrison's pouch), LUQ (perisplenic), right paracolic gutter, left paracolic gutter and pelvis-fluid in 1 location corresponds to minimal ascites, fluid in 2 locations -mild ascites, fluid in 3 locations -moderate ascites, fluid in 4 locations -marked ascites and fluid in 5 locations -massive ascites.…”

Atypical Presentation of Severe Dengue in a Patient following a Major Abdominal Surgery

“…Recent studies point to an increase in unusual presentations and severe disease [2,[4][5][6][7]. Severe dengue infection in a postoperative patient may lead to significant derangement in the body's homeostasis resulting in morbidity [8,9]. Reports on presentation and clinical manifestations of dengue in patients following major surgical procedures are scarce and restricted to few case reports [9].…”