A case report of dengue haemorrhagic fever complicated with psoas haematoma requiring blood transfusion

Spontaneous retroperitoneal haematoma in severe dengue: A case report

Dengue is endemic in over 100 countries worldwide, predominantly in the subtropical and tropical regions and the incidence has been increasing globally. Patients with severe dengue may develop massive bleeding, disseminated intravascular coagulopathy and multi-organ failure. Bleeding may occur in various body cavities and muscles; however, bleeding in the retroperitoneal space is uncommon. We report a case of a 37-year-old gentleman who presented with a 4-day history of fever associated with chills and rigours. On Day 6 of illness, he complained of left lumbar and left iliac fossa pain which was aggravated by movement. A computed tomography angiography scan of the abdomen showed the presence of a retroperitoneal haematoma, left iliopsoas and quadratus lumbarum intramuscular haematoma with active bleeding and left abdominal wall muscles haematoma. His condition gradually improved after multiple blood transfusions and he gained full recovery. Spontaneous retroperitoneal haematoma is an uncommon complication of severe dengue infection. Early diagnosis based on high index of clinical suspicion using appropriate imaging will aid in prompt management of these cases and may prevent deaths.

A rare presentation of dengue fever: bilateral psoas muscle hematoma, intrahepatic cholestatic hepatitis, pancreatitis and pancytopenia

Dengue is the foremost cause of arthropod-borne viral disease in the world. It is and commonly found in tropical and subtropical parts of the world. Dengue fever is caused by one of the four distinct serotypes (DENV 1-4) of single-stranded RNA Flavivirus genus and transmitted through Aedes mosquito. Infection caused by one serotype develops lifelong immunity to that serotype, but not to others. Dengue fever (DF) presents with high fever, headache, myalgia, and arthralgia, and rash. Severe dengue, dengue haemorrhagic fever (DHF), and dengue shock syndrome (DSS) are accompanied by thrombocytopenia, vascular leakage, and hypotension. DSS is characterized by shock, which can be fatal with case fatality high as 12% to 44%. There are few atypical manifestations of dengue fever growing with rising disease burden, often missed and sometimes difficult to diagnosis. In this case report, we will discuss atypical manifestations of bilateral psoas muscle hematoma, intrahepatic cholestatic hepatitis, pancreatitis and pancytopenia observed in dengue fever patient.

A Fatal Case of Dengue-Associated Hemophagocytic Lymphohistiocytosis and Retroperitoneal Hematoma in a Patient With Autoimmune Hemolytic Anemia

Hemophagocytic lymphohistiocytosis (HLH) is a rare but potentially life-threatening complication of dengue infection which necessitates early diagnosis and treatment to improve patient outcomes. Severe dengue infection complicated by HLH may require interventions such as systemic corticosteroids, intravenous immunoglobulin, or chemotherapy. Here, we report a case of concurrent dengue-induced HLH and flare of underlying autoimmune hemolytic anemia (AIHA). The disease was refractory to treatment including corticosteroids and intravenous immunoglobulin. The course of illness was later complicated by dengue shock syndrome, severe liver dysfunction, and a large retroperitoneal hematoma. Unfortunately, the patient succumbed on day 10 of illness.

A Case of Dengue Fever With Hemorrhagic Manifestations

Dengue fever is an arboviral infection spread by the Aedes mosquito with a wide spectrum of presentations encompassing simple flu-like illness to hemorrhagic manifestations. Hemorrhagic complications range from simple petechiae and purpura to gastrointestinal bleeding, hematuria, and severe central nervous system (CNS) bleeds. Herein we present a case of a 38-year-old male with dengue fever along with its hemorrhagic manifestations. Additionally, we conducted an extensive review of the literature to elucidate pathophysiology, diagnosis, and management of hemorrhagic manifestations in dengue fever.