Cardiac tamponade in a patient with severe dengue fever

Abstract

A 26-year-old postpartum female presented with symptoms characteristic of dengue fever on the 16 th day of puerperium. On the third day of the illness, the patient presented a clinical picture consistent with shock. Tests determined primary infection with dengue virus serotype 2. Cardiac tamponade was confirmed by echocardiography. This rare manifestation is described in a patient without any associated comorbidity.

Cardiac involvement in patients of dengue fever in reference to ECG and Echocardiography – A tertiary care center study

“…As a result, fluid resuscitation in dengue should be guided by hematocrit, blood pressure, and urine output as overzealous fluid therapy can cause pericardial effusion [15]. The postulated underlying mechanisms for reduced left ventricular ejection fraction are immune in origin although myocarditis may be a contributory factor [16].…”

Pyopericardium progressing to cardiac tamponade in a patient with dengue fever

“…Tamponade has been reported by Kumar et al in a patient with Lupus and Bendwal et al where dengue was a secondary infection, presenting with normal cardiac enzymes and minimal decrease in platelet counts, and 500 ml and 1500 ml of pericardial fluid tapping was done, respectively [9] , [10] . Fernandes et al in a postpartum lady, and Biswas et al reported cardiac tamponade where dengue was a primary infection, where platelet counts were more than one lakhs, the cardiac marker was raised, and 280 ml of pericardiocentesis was done in later mentioned study [11] , [12] . In our case, dengue was a primary infection with a normal platelet count and initial normal cardiac biomarkers.…”

Dengue associated with severe cutaneous leukocytoclastic vasculitis and pericardial effusion: a case report

“…As stated, another rare manifestation of the disease is cardiac tamponade. Although milder cardiac signs are commonly described in the literature, there are reports of more severe cardiac conditions 6,14 . However, to our knowledge, this is the first case involving two close clinical manifestations: leukocytoclastic vasculitis and pericardial effusion, with imminent cardiac tamponade.…”

“…Cardiac manifestations, which are often benign, may also occur. More severe manifestations such as myocarditis and small pericardial effusions may also occur, however, they rarely manifest as cardiac tamponade 6 . The evolution of dengue to pericardial effusion is also rare, especially when associated with leukocytoclastic vasculitis.…”