Rationale:Dengue fever is a viral infection that is spread through the bites of infected female Aedes mosquitos.It can cause life threatening complications,including dengue haemorrhagic fever(DHF)and dengue shock synd...Rationale:Dengue fever is a viral infection that is spread through the bites of infected female Aedes mosquitos.It can cause life threatening complications,including dengue haemorrhagic fever(DHF)and dengue shock syndrome.Patient concerns:A 15-year-old male presented with fever and petechiae and later developed hemoptysis.Diagnosis:Dengue fever with DHF with diffuse alveolar hemorrhage.Interventions:Invasive ventilation with high positive end expiratory pressure,multiple transfusions of packed red blood cells,fresh frozen plasma,single donor platelets and inotropic support Outcomes:The patient was stabilized and discharged on minimal supplemental oxygen.Lessons:Diffuse alveolar hemorrhage,although very rare,should be considered in a patient with dengue who presents with hemoptysis.The treatment is directed at providing respiratory and circulatory support,and preventing the progression of microcirculation damage.展开更多
Objective:To investigate the association between diagnosis delays and mortality in patients with haemorrhagic fever in Upper Southern Thailand.Methods:A hospital-based case control study was conducted between December...Objective:To investigate the association between diagnosis delays and mortality in patients with haemorrhagic fever in Upper Southern Thailand.Methods:A hospital-based case control study was conducted between December 2019 and January 2020.Cases were defined as patients who had been diagnosed with haemorrhagic fever and died during hospitalization,while controls were patients with similar conditions who survived.Medical records were retrospectively reviewed,with the primary variable being a diagnosis delay of more than three days after the onset of illness.The outcome of interest was mortality during hospitalization.Data analysis involved descriptive statistics and multiple logistic regression.Results:A total of 38815 haemorrhagic fever cases were reported from 2014 to 2019.The case-to-control ratio was 1:3,comprising 66 cases and 198 controls.Among 66 cases and 198 controls,the median(IQR)time from illness onset to diagnosis was 4(4)days in cases vs.1(0)day in controls.Diagnosis delays significantly increased mortality risk[adjusted OR(aOR)5.60,95%CI 2.74-11.46].Other risk factors for mortality included age≤5 years(aOR 16.15,95%CI 3.70-70.42)and overweight status(aOR 3.43,95%CI 1.57-7.52).Conclusions:Delayed diagnosis in patients with haemorrhagic fever was strongly associated with higher mortality rates.These findings highlight the critical importance of early diagnosis to reduce mortality in haemorrhagic fever cases.展开更多
Rationale:Hemophagocytic lymphohistiocytosis(HLH)is a rare but severe complication of dengue virus infection,associated with high mortality.We report a case of a 9-week primigravida presenting with high grade fever sp...Rationale:Hemophagocytic lymphohistiocytosis(HLH)is a rare but severe complication of dengue virus infection,associated with high mortality.We report a case of a 9-week primigravida presenting with high grade fever spikes and a positive Dengue NS1 antigen.The patient exhibited worsening clinical parameters,including cytopenias.Patient concerns:A primigravida at 9th week of gestation and this condition has limited diagnostic modalities and treatment options for HLH.Diagnoses:HLH secondary to dengue hemorrhagic fever.Outcomes:Intravenous steroids were initiated with monitoring of laboratory and clinical parameters.The patient recovered successfully after initiation of intravenous steroids.Oral steroids were subsequently tapered over an next eight-week period,leading to a successful recovery.Lessons:This case is unique due to the interplay between dengue virus infection,HLH,and early pregnancy,characterized by overlapping clinical symptoms and limited treatment options.Prompt initiation of intravenous steroid therapy resulted in significant clinical improvement.This case highlights the critical importance of early identification and treatment of dengue associated HLH to reduce mortality.Furthermore,it underscores the urgent need for focused research on HLH in pregnant patients,particularly in low and middle income countries.展开更多
文摘Rationale:Dengue fever is a viral infection that is spread through the bites of infected female Aedes mosquitos.It can cause life threatening complications,including dengue haemorrhagic fever(DHF)and dengue shock syndrome.Patient concerns:A 15-year-old male presented with fever and petechiae and later developed hemoptysis.Diagnosis:Dengue fever with DHF with diffuse alveolar hemorrhage.Interventions:Invasive ventilation with high positive end expiratory pressure,multiple transfusions of packed red blood cells,fresh frozen plasma,single donor platelets and inotropic support Outcomes:The patient was stabilized and discharged on minimal supplemental oxygen.Lessons:Diffuse alveolar hemorrhage,although very rare,should be considered in a patient with dengue who presents with hemoptysis.The treatment is directed at providing respiratory and circulatory support,and preventing the progression of microcirculation damage.
文摘Objective:To investigate the association between diagnosis delays and mortality in patients with haemorrhagic fever in Upper Southern Thailand.Methods:A hospital-based case control study was conducted between December 2019 and January 2020.Cases were defined as patients who had been diagnosed with haemorrhagic fever and died during hospitalization,while controls were patients with similar conditions who survived.Medical records were retrospectively reviewed,with the primary variable being a diagnosis delay of more than three days after the onset of illness.The outcome of interest was mortality during hospitalization.Data analysis involved descriptive statistics and multiple logistic regression.Results:A total of 38815 haemorrhagic fever cases were reported from 2014 to 2019.The case-to-control ratio was 1:3,comprising 66 cases and 198 controls.Among 66 cases and 198 controls,the median(IQR)time from illness onset to diagnosis was 4(4)days in cases vs.1(0)day in controls.Diagnosis delays significantly increased mortality risk[adjusted OR(aOR)5.60,95%CI 2.74-11.46].Other risk factors for mortality included age≤5 years(aOR 16.15,95%CI 3.70-70.42)and overweight status(aOR 3.43,95%CI 1.57-7.52).Conclusions:Delayed diagnosis in patients with haemorrhagic fever was strongly associated with higher mortality rates.These findings highlight the critical importance of early diagnosis to reduce mortality in haemorrhagic fever cases.
文摘Rationale:Hemophagocytic lymphohistiocytosis(HLH)is a rare but severe complication of dengue virus infection,associated with high mortality.We report a case of a 9-week primigravida presenting with high grade fever spikes and a positive Dengue NS1 antigen.The patient exhibited worsening clinical parameters,including cytopenias.Patient concerns:A primigravida at 9th week of gestation and this condition has limited diagnostic modalities and treatment options for HLH.Diagnoses:HLH secondary to dengue hemorrhagic fever.Outcomes:Intravenous steroids were initiated with monitoring of laboratory and clinical parameters.The patient recovered successfully after initiation of intravenous steroids.Oral steroids were subsequently tapered over an next eight-week period,leading to a successful recovery.Lessons:This case is unique due to the interplay between dengue virus infection,HLH,and early pregnancy,characterized by overlapping clinical symptoms and limited treatment options.Prompt initiation of intravenous steroid therapy resulted in significant clinical improvement.This case highlights the critical importance of early identification and treatment of dengue associated HLH to reduce mortality.Furthermore,it underscores the urgent need for focused research on HLH in pregnant patients,particularly in low and middle income countries.
