Acute appendicitis during the recovery phase of dengue hemorrhagic fever: two case reports 

Abstract

Background Dengue fever is one of the most common tropical diseases, with high prevalence in many tropical countries including Sri Lanka. Dengue infection can present from subclinical infection to dengue shock syndrome. Further, the disease also shows a variety of atypical presentations and has been reported to mimic a number of causes of acute abdomen. Case presentation The authors report two children (a 6-year-old Tamil girl and an 8-year-old Muslim girl) who were diagnosed to have acute appendicitis during the early recovery phase of dengue hemorrhagic fever (DHF) and late recovery period of dengue hemorrhagic fever with platelet count of 92 × 103/cumm and 102 × 103/cumm, respectively. Both children were investigated with abdomen ultrasound as they developed severe abdominal pain and tenderness on palpation during the recovery phase, which was felt to be very unusual. Acute appendicitis was diagnosed in one child, while the other child had a ruptured appendicular abscess. Both children were treated with laparoscopic appendectomy and a 7-day course of intravenous antibiotics. Both children were reviewed in 1 month following treatment and had complete recovery. Conclusion Although precise pathophysiology and associations of the surgical abdomen with dengue fever remain to be elucidated, there are known factors in dengue fever that can potentially lead to secondary bacterial infections and surgical abdomen. Awareness and increased suspicion by the clinician are paramount to detect such complications early, especially in children who demonstrate unusual clinical features during various stages of dengue infection.

Risks of Acute Cholecystitis, Acute Pancreatitis, and Acute Appendicitis in Patients with Dengue Fever: A Population-Based Cohort Study in Taiwan

“…Although case reports of acute appendicitis during acute DENV infection have been documented [ 13 , 39 , 56 , 57 ], our study found no significant increase in the risk of acute appendicitis in the first month or first year following DENV infection. However, we found a slightly increased risk of acute appendicitis after 1 year of DENV infection (aHR 1.32; P < 0.0001); the results remained statistically significant after adjusting for multiple comparisons, suggesting that the results were unlikely due to type 1 error.…”

Stagnant Cleaning Affects Dengue Hemorrhagic Fever Incidence: A Rapid Survey

“…According toThadchanamoorty, et al Dengue fever is a viral infection transmitted by mosquitoes and is recognized as a tropical disease that is often neglected by the World Health Organization (WHO), this condition has had a major impact on the Sri Lankan economy in providing primary and secondary health care over the past two decades. It has a myriad of clinical manifestations that range from self-resolving subclinical infection to fatal dengue shock syndrome, atypical presentation and multiorgan involvement recognized under the umbrella of expanded dengue syndrome in 2012 by WHO, various manifestations reported in expanded dengue syndrome, including cardiac involvement , brain, kidney, liver, spleen, pancreas, and gastrointestinal tract, complications that are not commonly reported are myocarditis, encephalitis, (Thadchanamoorthy et al, 2022).…”