Spontaneous arterial hemorrhage as a complication of dengue

Rao, Shoma V.; Jacob, Gijoe George; Raju, Nithin Abraham; Ancheri, Sneha Ann

doi:10.4103/0972-5229.182201

Cited by 10 publications

(7 citation statements)

References 8 publications

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“…Different gastrointestinal tract (GIT) symptoms, such as vomiting and abdominal pain, were observed in 32.01% and 29.71% of cases, possibly due to dengue virus-mediated liver injury [12,16]. Bleeding manifestations such as petechiae, GIT bleeding, gum bleeding, and hematuria were observed in 42.89%, 13.18%, 10.25%, and 09.41% of cases, respectively, which could be due to the consequences of thrombocytopenia and imbalance between clotting and the fibrinolysis system [19][20][21].…”

Section: Discussionmentioning

confidence: 99%

Clinical Profile, Severity Spectrum, and Hospital Outcome of Dengue Patients in a Tertiary Care Hospital in Dhaka City

Islam¹,

Hasan²,

Kalam³

et al. 2022

Cureus

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BackgroundBangladesh saw its most severe dengue outbreak in 2019, with the highest number of deaths reported. This study investigated the clinical characteristics, severity spectrum, and potential outcomes of dengue in patients admitted to a tertiary care institution in Dhaka. MethodsThis prospective observational study was done between May 2019 to April 2020. A total of 478 nonstructural protein 1 (NS1) antigen positive confirmed dengue cases were finally enrolled. The dengue patient's stratification and severity grading were performed according to the World Health Organization (WHO) dengue guidelines, for diagnosis, treatment, prevention, and control (2009). In addition, in-hospital outcomes were assessed in terms of mortality. ResultsThe patient's mean age was 33.90±15.82 (SD) years. The male-to-female ratio was 1.23:1. In addition to fever, the most common symptoms were myalgia (67.78%) and rashes (58.58%). According to WHO classification 33.90% of patients (n=162) were in group A, 49.40% (n=236) were in group B, and 16.70% (n=80) were in group C. The overall mortality was 1.23% in groups A, 2.97% in group B, and 11.25% in group C. The mortality was higher in the more severe group with statistical significance (p<0.001). The mean hospital stay time was significantly less in the surviving group (survival vs. death: 3.07±1.78 vs. 5.61±3.13 SD {days}, p<0.001). Leukopenia and thrombocytopenia were commonly seen in all of the severity groups. ConclusionDengue epidemics are increasing in Bangladesh. Many group B and C cases are fatal. To reduce mortality and morbidity, health care providers must remain alert. This challenge requires public health interventions and hospital readiness.

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Section: Discussionmentioning

confidence: 99%

Clinical Profile, Severity Spectrum, and Hospital Outcome of Dengue Patients in a Tertiary Care Hospital in Dhaka City

Islam¹,

Hasan²,

Kalam³

et al. 2022

Cureus

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“…These included the eyes (bilateral narrow anterior chamber), pancreas (edema), small and large intestines (small bowel edema, jejunal-ileal and ileocecal intussusception, and edematous appendix), knee (joint effusion), and muscles (thickened psoas, rapidly expanding hematoma in the intramuscular plane of the right lower abdomen). [20][21][22][23][24][25][26][27][28][29][30][31][32][33][34] Gold standard comparisons and outcome measurements. Comparison of ultrasound examinations against a gold standard was reported in only 9% (n = 16) of studies.…”

Section: Resultsmentioning

confidence: 99%

Ultrasound in Dengue: A Scoping Review

Dewan

Zuluaga

Osório

et al. 2021

The American Journal of Tropical Medicine and Hygiene

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To improve dengue triage and treatment decisions, the WHO recommends classifying the disease as dengue with or without warning signs or severe dengue. Vascular leakage is a key component of the pathophysiology of severe dengue and is detectable by ultrasound. The objective of this scoping review is to describe the primary literature on the use of ultrasound in dengue, summarize the findings, and identify knowledge gaps. Our database search retrieved 1,489 records which were reduced to 177 studies following eligibility screening. Descriptive analyses were conducted. Results showed most studies are from South Asia (n = 92, 52%) and assessed hospitalized dengue patients (130, 82%). Radiologists were the most reported ultrasonographers (14, 8%), and conventional ultrasound (39, 68%) was preferred over portable (9, 16%). The most common ultrasound findings in dengue were ascites (107, 60%), pleural effusion (102, 58%), and gallbladder wall thickening (97, 55%). However, the lack of a standard protocol to perform the ultrasound examination in dengue patients hinders conclusions about the frequency of ultrasound findings in dengue. Given the progress of current ultrasound technology, a focused point-of-care ultrasound protocol for early detection of vascular leakage in dengue is needed to generate the evidence required for its implementation in routine care.

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“…Previous studies have reported a significant number of RSH-associated risk factors that generally are divided into two categories, traumatic and non-traumatic ones. Non-traumatic causes of RSH involve various underlying medical conditions such as anticoagulation therapy or infectionrelated coagulation abnormalities [8,9].…”

Section: Discussionmentioning

confidence: 99%

Fondaparinux–Associated Rectus Sheath Hematoma: Skating on Thin Ice

Sabanis¹,

Drylli

Mamakou³

et al. 2020

Cureus

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Rectus sheath hematoma (RSH), an exceptionally rare clinical entity, results from the rupture of epigastric arteries or tear of the rectus abdominis muscle itself. Spontaneous RSH represents a potentially life-threatening bleeding complication in anticoagulated patients with distinct characteristics. The non-specific nature of RSH clinical manifestations renders RSH a kaleidoscopic disease that may be misdiagnosed. The widespread use of anticoagulants for deep vein thrombosis (DVT) prophylaxis or therapy is among the most commonly documented risk factors. To the best of our knowledge, this is the first report of a fondaparinux-associated giant RSH in a 58-year-old Caucasian man who presented with severe pain at the right abdominal quadrant accompanied with a large ecchymosis secondary to violent cough due to a respiratory infection. The aim of our study is to broaden current knowledge regarding the predisposing factors, the pathophysiological mechanisms, and the management of this bleeding disorder.

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Spontaneous arterial hemorrhage as a complication of dengue

Cited by 10 publications

References 8 publications

Clinical Profile, Severity Spectrum, and Hospital Outcome of Dengue Patients in a Tertiary Care Hospital in Dhaka City

Clinical Profile, Severity Spectrum, and Hospital Outcome of Dengue Patients in a Tertiary Care Hospital in Dhaka City

Ultrasound in Dengue: A Scoping Review

Fondaparinux–Associated Rectus Sheath Hematoma: Skating on Thin Ice

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