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Carvalho LIMD, Azi LMTDA, Leal PDC, Lorentz MN, Diego LADS, Schmidt AP. Anesthesia and perioperative care management in patients with Dengue Fever: considerations and challenges. BRAZILIAN JOURNAL OF ANESTHESIOLOGY (ELSEVIER) 2024; 74:844511. [PMID: 38723714 PMCID: PMC11233874 DOI: 10.1016/j.bjane.2024.844511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/18/2024]
Affiliation(s)
| | - Liana Maria Tôrres de Araújo Azi
- Hospital Universitário Professor Edgard Santos, Departamento de Anestesiologia, Salvador, BA, Brazil; Universidade Federal da Bahia (UFBA), Salvador, BA, Brazil
| | - Plinio da Cunha Leal
- Hospital São Domingos, Departamento de Anestesiologia, São Luís, MA, Brazil; Universidade Federal do Maranhão (UFMA), São Luís, MA, Brazil
| | | | | | - André P Schmidt
- Hospital de Clínicas de Porto Alegre (HCPA), Serviço de Anestesia e Medicina Perioperatória, Porto Alegre, RS, Brazil; Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Santa Casa de Porto Alegre, Serviço de Anestesia, Porto Alegre, RS, Brazil; Hospital Nossa Senhora da Conceição, Serviço de Anestesia, Porto Alegre, RS, Brazil; Universidade Federal do Rio Grande do Sul (UFRGS), Programa de Pós-graduação em Ciências Pneumológicas, Porto Alegre, RS, Brazil; Universidade Federal do Rio Grande do Sul (UFRGS), Programa de Pós-graduação em Ciências Cirúrgicas, Porto Alegre, RS, Brazil; Faculdade de Medicina da Universidade de São Paulo (FMUSP), Programa de Pós-Graduação em Anestesiologia, Ciências Cirúrgicas e Medicina Perioperatória, São Paulo, SP, Brazil
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Kumar M, Karthikeyan A, Karthikeyan VS. Dengue shock syndrome after percutaneous nephrolithotomy leading to hematuria and renal failure: A rare complication. Indian J Urol 2020; 36:136-137. [PMID: 32549667 PMCID: PMC7279105 DOI: 10.4103/iju.iju_335_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2019] [Revised: 03/10/2020] [Accepted: 03/12/2020] [Indexed: 11/11/2022] Open
Abstract
Hematuria following percutaneous nephrolithotomy (PCNL) is a dreaded complication. It necessitates blood transfusion in up to 10% of patients. It may be severe enough in <1% of patients to require angioembolization. We present a 50-year-old male who underwent PCNL for renal pelvic calculus. Since the day of the surgery, he had low-grade fever (100°F) which worsened (102°F) from the 2nd postoperative day. His preoperative urine culture was sterile. His platelet counts started dropping and NS1 antigen for dengue was positive. He also developed anemia (hemoglobin: 7g%) and platelet counts dropped to 17,000/cmm. He developed anuria on the 7th postoperative day, with serum creatinine rising to 7 mg%. He required two sessions of hemodialysis and urine output improved. There is a need for high index of suspicion for dengue, especially when fever and hematuria coexist in post PCNL patients.
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Affiliation(s)
- Manish Kumar
- Department of Urology, Sri Narayani Hospital and Research Centre, Vellore, Tamil Nadu, India
| | - Aswathaman Karthikeyan
- Department of Urology, Sri Narayani Hospital and Research Centre, Vellore, Tamil Nadu, India
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Ehelepola NDB, Athurupana AASD, Bowatte PGCS, Dissanayake WP. Continuation of Dual Antiplatelet Therapy in a Patient with a Coronary Artery Stent with Dengue Hemorrhagic Fever: A Clinical Conundrum. Am J Trop Med Hyg 2020; 102:17-19. [PMID: 31701855 DOI: 10.4269/ajtmh.19-0512] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
Severe thrombocytopenia with impairment of the activity of platelets and impairment of blood clotting occurs in dengue hemorrhagic fever (DHF). Continuation of dual antiplatelet therapy in such patients can result in life-threatening hemorrhages. On the other hand, withholding of antiplatelets in a patient undergone coronary stenting lately can lead to stent thrombosis, resulting in myocardial infarctions and sudden cardiac death. There are no guidelines on management of DHF in patients with coronary stents. Here, we discuss about several divergent factors that need to be considered and balanced when managing such patients. We describe a case as an example to illustrate how we balanced the risk of serious bleeding versus the risk of stent thrombosis successfully according to evolution of the disease process, by temporary withholding of antiplatelets in such a patient.
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