Series of 10 dengue fever cases with unusual presentations and complications in Sri Lanka: a single centre experience in 2016.

Abstract:

BACKGROUND:Dengue has global importance as a dreaded arboviral infection. It has 4 serotypes of epidemiological imporatnce. The classification denotes two clinical spectrums- dengue fever (DF) and dengue haemorragic fever (DHF). Most cases are stereotype and amenable to fluid resuscitation. However, unusual manifestations cause fatalities and often overlooked. This study describes 10 such dengue cases to fill the knowledge gaps. CASE PRESENTATION:All 10 patients presented to the Teaching Hospital, Peradeniya, Sri Lanka during mid-year epidemic of dengue in 2016. The mean age is 27 years (range 12-51 years) comprising 6 females and 4 males. The group had 7 DHF, 3 DF and 2 primary dengue infections who predominantly had severe bleeding into gut. Other potentially life threatening problems were acute severe hepatitis, severe septic shock, myocarditis, erratic rapid plasma leak, intracranial bleeding, diarrhoea and decompenstaed dengue shock due to 3rd space fluid leak. Blood transfusions and other empirical therapeutic methods were used apart from meticulous fluid management to suit issues of each patient. Bedside ultrasound scanning helped early detection of critical phase. All recovered fully. CONCLUSIONS:Dengue is an extremely challenging infection to treat in the globe today. Above unusual presentation and complications could be fatal, if not detected early where therapeutic window period is very short. Clinicians need awareness of these problems which are not uncommon, but underreported and often overlooked. The clinical management of each patient was described for the purpose sharing the experiences.

journal_name

BMC Infect Dis

journal_title

BMC infectious diseases

authors

Kularatne SAM,Ralapanawa U,Dalugama C,Jayasinghe J,Rupasinghe S,Kumarihamy P

doi

10.1186/s12879-018-3596-5

subject

Has Abstract

pub_date

2018-12-18 00:00:00

pages

674

issue

1

issn

1471-2334

pii

10.1186/s12879-018-3596-5

journal_volume

18

pub_type

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