Dengue Infections and the Surgical Patient

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.

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“…Direct viral invasion can also lead to acute appendicitis. Other proposed mechanisms include endotoxemia and ischemic reperfusion injury [ 19 ].…”

Section: Discussionmentioning

confidence: 99%

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

et al. 2022

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“…1 Reports from different parts of the world suggest a changing pattern in the incidence of dengue infections and associated organ involvement such as respiratory, cardiac, gastrointestinal, hepatic, renal and neurological. [2][3][4][5][6][7][8][9] In Sri Lanka, dengue epidemics occur regularly and cause considerable financial burden to the health care sector and economy of the country. 10,11 Although children are commonly affected by dengue, published data on dengue infections in children living in Sri Lanka are limited.…”

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Clinical and Biochemical Characteristics of Dengue Infections in Children From Sri Lanka

Jayarajah

Madarasinghe²,

Hapugoda³

et al. 2020

Global Pediatric Health

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Introduction: Analyzing dengue disease patterns from different parts of the world should help us formulate more evidence based treatment guidelines and appropriately allocate limited healthcare resources. Therefore, we described the disease characteristics of hospitalised pediatric patients with dengue infections from Sri Lanka during the 2017 dengue epidemic. Methods: Clinical and biochemical characteristics of pediatric dengue patients treated at a secondary care hospital in Sri Lanka from 1 June 2017 to 31 August 2017 were analyzed. Our findings were compared with previous pediatric dengue studies in Asia. Results: A total of 305 patients (number of males = 184(60%); mean age = 8.6 years) were analyzed. DF (Dengue Fever)—245 (80.3%), DHF (Dengue Hemorrhagic fever)—I:52 (17%), DHF—II:7 (2.3%), and DHF—III:1 (0.3%). Significant associations were found between DHF and abdominal symptoms/signs and overt bleeding manifestations ( P < .001). Time of onset of the critical phase was variable (Day 3: 12%, Day 4-5: 78%, Day 6: 5%, and Day 7: 5%). Platelet and white-cell counts (WBC) were significantly lower in DHF than DF; liver enzyme derangement was mild and was similar in the DHF and DF subgroups. None had cardiac, renal, or neurological manifestations and all recovered uneventfully. Conclusion: In Sri Lankan pediatric dengue patients, we found abdominal symptoms and signs, decreased WBC and platelet counts and bleeding manifestations were to be significantly associated with DHF. Liver enzyme derangement did not predict DHF. The time of onset of the critical phase was difficult to predict due to the considerable variations noted.

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“…Another systemic review and metaanalysis conducted by Jayarajsh and colleagues in which 22 studies were included and most of them from South Asia has shown that acute abdomen sometimes the main complaint of patients with dengue infection and its cumulative prevalence was 16%. 22 Understanding these complaints in patients with dengue has multiple benefits for the patients and also for the physicians. Timely identification of such patients reduces the cost of unnecessary admission, investigations, and procedures.…”

Section: Discussionmentioning

confidence: 99%

Frequency of Gastrointestinal Signs and Symptoms in Patients with Dengue Fever in Tertiary Care Hospital

Abrar¹,

Selamat²,

Abbasi³

et al. 2023

PJMHS

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Objective: The objective behind this study was to determine the frequency of gastrointestinal signs and symptoms in patients with dengue fever in tertiary care hospital Methods: A cross sectional observational study was conducted on all adult patients diagnosed with dengue disease after taken informed consent from the patients and approval from the ethical committee of the hospital. All these patients were evaluated for the presence or absence of gastrointestinal (GI) manifestations. Those who had GI symptoms were further evaluated for the frequency of different types of GI symptoms. All baseline and clinical data were taken using a structured questionnaire and then entered & analysed using SPSS v. 26. Results: A total of 174 patients who were dengue virus positive were included for final analysis. Overall mean age and SD was 29.22±8.14 years and majority belongs to young age group, ≥16 – 40 years (60.11%, n = 104). Most of our study participants were males (75.86%, n = 132). Hypertension was the most common comorbid condition observed in our study participants (12.06%, n = 21). The overall prevalence of GI manifestations in our study who were dengue positive was 62.64% (n = 109). The most common GI symptom was presence of nausea/vomiting (70.64%, n = 77). Conclusion: The prevalence of GI manifestations in patients with dengue is quite high. Nausea/vomiting was the most common GI manifestation while patients with hepatomegaly and GI bleeding were also prevalent. Keywords: Dengue fever, gastrointestinal symptoms, clinical manifestation, Pakistan

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Dengue Infections and the Surgical Patient

Cited by 12 publications

References 90 publications

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

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

Clinical and Biochemical Characteristics of Dengue Infections in Children From Sri Lanka

Frequency of Gastrointestinal Signs and Symptoms in Patients with Dengue Fever in Tertiary Care Hospital

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