Dengue Expanded Syndrome: An unusual presentation

Dengue fever is a mosquito borne viral infection found in tropic & sub-tropic regions. The symptomatic dengue infection follows an uncomplicated course; however, unusual manifestations of this disease are now being increasingly reported as expanded dengue syndrome which incorporates wide spectrum of uncommon presentation of this common disease which does not fall into either dengue shock syndrome or dengue hemorrhagic fever. We report a case of a 30 year old lady who presented with high grade fever, rash, diffuse abdominal pain & vomiting, who ultimately developed shock and features of multi organ failure. We diagnosed her as a case of expanded dengue syndrome with multi organ failure ( hepatitis with very high transaminase levels, pancreatitis, acalculous cholecystitis, coagulation failure & acute kidney injury) with septicaemia. With prompt diagnosis and aggressive management, this potentially fatal patient was cured.Bangladesh J Medicine Jan 2018; 29(1) : 45-47

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Clinico-epidemiological study of dengue fever in Ajmer region

International Journal of Contemporary Pediatrics ◽

10.18203/2349-3291.ijcp20193722 ◽

2019 ◽

Vol 6 (5) ◽

pp. 2046

Author(s):

Dharmendra Rawat ◽

Kanwar Singh ◽

Pukhraj Garg

Keyword(s):

Dengue Fever ◽

Case Fatality Rate ◽

Wide Spectrum ◽

Dengue Infection ◽

Case Fatality ◽

Hemorrhagic Fever ◽

Severe Dengue ◽

Common Disease ◽

Hemorrhagic Disease ◽

Fatality Rate

Background: Dengue infection is a major challenge to public health, especially in South-East Asia. It present with a diverse clinical spectrum. Estimates suggest that annually over 50 million cases of dengue hemorrhagic fever (DHF) occur in Asian countries with a case fatality rate of less than 5%. Of those with DHF, at least 90% are children younger than 15 years old. In humans, dengue infection causes a spectrum of illness ranging from relatively mild, non-specific viral syndrome known as Dengue fever (DF) to severe hemorrhagic disease and death. Definitive early Dengue diagnosis requires laboratory tests and those suitable for use at this stage of illness are either costly, such as RT-PCR for Dengue; not sufficiently rapid, such as virus isolation. Currently test available are NS1 antigen detection and ELISA for dengue, IgM and IgG antibodies. Objective of this study is to study clinico-epidemiological and haematological features of Dengue infection.Methods: Prospective observational study involving initial 100 registered cases who were serologically confirmed dengue infection for a period of one year.Results: DF, DHF and DSS were found in 41%, 53% and 6% patients respectively. Most common presenting complaint and bleeding manifestation were fever and petechiae. Uncommonly altered sensorium and icterus were found in severe dengue infection. 6% patients had coagulopathy, 37 patients had hepatic involvement and 2 patients had deranged renal function who had DSS. Fever was present in (100%) cases of DF, DHF and DSS. 26% patients had their platelet count <50000/mm3.Conclusions: Dengue is a common disease in the India with wide spectrum of clinical presentations, affecting 5-15 years age group children commonly. It is one of the dreaded fevers but early diagnosis and management according to recent WHO guidelines can decrease case fatality rate significantly.

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Clinical profile of dengue fever in children: analysis of 2017 outbreak from Central Kerala, India

International Journal of Contemporary Pediatrics ◽

10.18203/2349-3291.ijcp20184293 ◽

2018 ◽

Vol 5 (6) ◽

pp. 2265 ◽

Cited By ~ 1

Author(s):

Senthil Kumar K. ◽

Rajendran N. K. ◽

Ajith Brabhukumar C.

Keyword(s):

Dengue Fever ◽

Dengue Infection ◽

Tertiary Care ◽

Hemorrhagic Fever ◽

Warning Signs ◽

Clinical Profile ◽

Severe Dengue ◽

High Morbidity ◽

Care Hospital ◽

High Grade Fever

Background: In India, dengue epidemics are becoming more frequent (WHO, 2008). The majority of dengue viral infections are self-limiting, but complications may cause high morbidity and mortality. The objective of this study is to assess the clinical profile of the dengue infection in children less than 15 years of age and to evaluate the outcomes of dengue fever from March 2017 to July 2017 at the Pediatric Department of Karuna Medical College, the tertiary care hospital in Palakkad.Methods: In this retrospective study, medical records were reviewed and analyzed. Patients with suspected dengue infection were classified further into 2 groups, Dengue fever (probable dengue, dengue with warning signs) and ‘Severe Dengue’ (dengue hemorrhagic fever and/or dengue shock syndrome (DHF/DSS) according to WHO.Results: A total of 77 cases were classified into 67 (87%) non-severe and 10 (13%) severe dengue cases. The most common age of presentation was above 10 yrs. The mean age of admission was 8.9 yrs. The most common presenting symptom was fever seen in 93% followed by vomiting in 68%. Elevation in Aspartate transaminase (SGOT) and thrombocytopenia were found in 32.4 %.Conclusions: High grade fever, vomiting, abdominal pain and skin rash with normal or low platelet count were the presenting features. Early diagnosis, monitoring and prompt supportive management can reduce mortality.

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Scrub typhus, a rare of cause of fulminant hepatic failure: A common disease with uncommon presentation

Indian Journal of Case Reports ◽

10.32677/ijcr.v7i12.3178 ◽

2022 ◽

pp. 526-528

Author(s):

Subramani Jagadeesan ◽

Pranav Patel ◽

Ajay Jain

Keyword(s):

Fulminant Hepatic Failure ◽

Hepatic Failure ◽

Scrub Typhus ◽

Kidney Injury ◽

Asia Pacific ◽

Common Disease ◽

Antibiotic Administration ◽

Elderly Male ◽

High Grade Fever ◽

Uncommon Presentation

Scrub typhus (bush typhus) is a potentially lethal mite-borne, acute febrile infectious illness caused by Orientia tsutsugamushi, reported precipitating frequent outbreaks in the Asia-pacific belt. Usual presentation after a median incubation period of 10–14 days, stretches from pathognomonic eschar, high-grade fever, centrifugal skin rash, jaundice, regional lymphadenopathy to frontal headache, nevertheless complicated at times with myocarditis, acute respiratory distress syndrome, acute kidney injury, encephalitis, and shock. Although patients with scrub typhus invariably do display mild liver injury, fulminant hepatic failure (FHF) is rarely reported. We describe herein, a case of FHF in an elderly male that responded well to antibiotics. Early diagnosis and sensitive antibiotic administration aids in mortality prevention of the former.

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Neurological complications in dengue infection: a review for clinical practice

Arquivos de Neuro-Psiquiatria ◽

10.1590/0004-282x20130147 ◽

2013 ◽

Vol 71 (9B) ◽

pp. 667-671 ◽

Cited By ~ 28

Author(s):

Marzia Puccioni-Sohler ◽

Carolina Rosadas ◽

Mauro Jorge Cabral-Castro

Keyword(s):

Clinical Practice ◽

Wide Spectrum ◽

Dengue Infection ◽

Clinical Signs ◽

Public Health Problem ◽

Hemorrhagic Fever ◽

Neurological Complications ◽

World Health ◽

World Population ◽

Global Public Health

Dengue is an important global public health problem. The World Health Organization estimates that 2/5 of entire world population are in risk of dengue infection. Almost 50 millions cases occur annually, with at least 20 thousand deaths. The etiological agent of this acute febrile disease is a single-strand positive-sense RNA virus of Flavivirus genus. It is an arboviral disease transmitted by Aedes sp. mosquitoes (Aedes aegypti and A. albopictus). Most infected individuals present asymptomatic infection, but some may develop clinical signs. Therefore, a wide spectrum of illness can be observed, ranging from unapparent, mild disease, called dengue fever, to a severe and occasionally fatal dengue hemorrhagic fever/dengue shock syndrome. Currently, neurological manifestations related to dengue infections are increasingly been observed and appears as a challenge for medical practice. In this study the neurological complications of dengue infection will be reviewed, focusing a better understanding of the disease for the clinical practice.

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Abstract #502: Newly Diagnosed Diabetes Mellitus Presenting as Chylomicronemia Syndrome an Uncommon Presentation of a Common Disease

Endocrine Practice ◽

10.1016/s1530-891x(20)45060-8 ◽

2016 ◽

Vol 22 ◽

pp. 116

Author(s):

Maha Sulieman ◽

Delamo Isaac Bekele ◽

Jennifer Marquita Carter ◽

Rabia Cherqaoui ◽

Vijaya Ganta ◽

...

Keyword(s):

Diabetes Mellitus ◽

Common Disease ◽

Newly Diagnosed ◽

Uncommon Presentation ◽

Diagnosed Diabetes ◽

Newly Diagnosed Diabetes

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Thirty-eight-negative-kinase-1 is a major mediator of trauma-induced intestinal injury and multi-organ failure

Zeitschrift für Gastroenterologie ◽

10.1055/s-0038-1668670 ◽

2018 ◽

Vol 56 (08) ◽

pp. e205-e206

Author(s):

M Armacki ◽

AK Trugenberger ◽

A Ellwanger ◽

T Eiseler ◽

L Bettac ◽

...

Keyword(s):

Organ Failure ◽

Intestinal Injury ◽

Multi Organ Failure ◽

Major Mediator

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A rare case of type-2 familial partial lipodystrophy (FLD type 2) non-Dunnigan type with laminin A/C gene (LMNA) mutation causing multi-organ failure and diabetes mellitus

Endocrine Abstracts ◽

10.1530/endoabs.56.gp123 ◽

2018 ◽

Author(s):

Simona Frunza-Stefan ◽

Raafia Memon ◽

Rana Malek ◽

Elizabeth Streeten ◽

Toni Pollin ◽

...

Keyword(s):

Diabetes Mellitus ◽

Organ Failure ◽

Rare Case ◽

Partial Lipodystrophy ◽

Lmna Mutation ◽

Multi Organ Failure ◽

Familial Partial Lipodystrophy

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Simultaneous Occurrence of Choriocarcinoma in an Infant and Mother

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18041934 ◽

2021 ◽

Vol 18 (4) ◽

pp. 1934

Author(s):

Małgorzata Rzanny-Owczarzak ◽

Joanna Sawicka-Metkowska ◽

Katarzyna Jończyk-Potoczna ◽

Ewelina Gowin ◽

Patrycja Sosnowska-Sienkiewicz ◽

...

Keyword(s):

Rare Disease ◽

Organ Failure ◽

Liver Tumor ◽

Serum Levels ◽

Simultaneous Occurrence ◽

Positive History ◽

Multi Organ Failure ◽

History Of

Infantile choriocarcinoma is an extremely rare disease. We present a case study of a 1-month-old male with choriocarcinoma diagnosed simultaneously with his mother. On admission to hospital, the disease was very advanced and massive progression and multi-organ failure caused the death of the patient despite the implemented treatment. It was too late to save the child’s life, but early enough to save his mother. The authors believe that the serum levels of hCG should be determined in every newborn with anemia and liver tumor, especially when the mother has a positive history of miscarriage.

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