The first fatal dengue virus infection case in Turkey: Autopsy findings

Abstract

Dengue is the fastest spreading arboviral infection in the world. It is responsible for about 50 to 200 million infections annually. Turkey is accepted in the World Health Organization European region and dengue is now endemic in all World Health Organization regions except for the European region, but people can travel anywhere in the world and they can catch a disease easily. Approximately 2.5 billion people live in dengue endemic countries; therefore, it may be endemic in Europe as well in the near future. It might be seen with increasing frequency in forensic mortuaries soon. In such a situation, the autopsy staff have to keep dengue virus infections in mind to protect themselves from contamination and to detect the cause of death. A case of a 65-year old Thailand citizen male who died in Turkey is presented. He had skin rashes all over the body. His internal examination revealed, 1900 ml, 1700 ml and 80 ml sero-hemorrhagic fluid in the right chest, left chest and pericardial cavities respectively. The sectional cuts of the lungs showed hemorrhagic fluid leakage. Ecchymosis due to intubation was found in the upper tracheal region. Mesocolon transversum showed hemorrhage as well. Blood test results showed Dengue Virus Immunoglobulin G (IFA) and Immunoglobulin M (IFA) positive, Japanese encephalitis virus Immunoglobulin M (IFA) negative and Immunoglobulin G (IFA) positive.

Three Cases of Dengue Fever from Maldives

“…2 Ülkemizden bildirilen vakalar importe vakalardır. 3,4 Ülkemiz kaynaklı vaka bildirimi yoktur. Fakat, seroepidemiyolojik çalışmalar Dang virüs varlığını işaret etmektedir.…”

“…3,4 Dubai'den Hindistan'a göç eden, bir hafta sonra DA tanısı alan 40 yaşındaki erkek hasta izlem altında iken, Türkiye'ye geldiğinde ekstremitelerinde döküntü, lökopeni, trombositopeni, karaciğer transaminaz enzim yüksekliği saptanmıştır. Diğeri ise 65 yaşında Tayland vatandaşı, Türkiye'ye seyahati sırasında ateş yüksekliği, plevral ve perikardiyal serohemorajik effüzyon, kardiyopulmoner arrest ile hastaneye getirilmiştir.…”

“…Maldivler'de yapılan tetkik sonuçları; 2 Maldivler'de Dang virüs Ig M ve G sonuçları negatif;3 Maldivler'de Dang virüs PZR sonucu pozitif;4 Maldivler'de NS1 antijen testi pozitif. ALT: Alanin aminotransferaz; AST: Aspartat transferaz; CK: Kreatin kinaz; LDH: Laktat dehidrogenaz; CRP: C-reaktif protein; Ig: İmmünglobulin; PZR: Polimeraz zincir reaksiyonu.…”