Abstract
A 26-year-old male presented with fever for five days and abdominal pain for 24 hours. System examination identified a soft abdomen with diffuse tenderness. CT-abdomen findings were consistent with splenic rupture with intra and peri-splenic hematoma. Laboratory investigations showed a platelet count of 40,000 per mm(3). In due course he developed hypotension and underwent splenectomy. Non-structural protein 1 (NS1) dengue antigen was positive in the admission sample and IgM dengue antibodies were detected in the follow-up sample. Histopathology of the spleen showed normal architecture with no evidence of hyperplasia, cellular infiltrates or haematological malignancy. Splenic rupture is a rare, but potentially fatal complication of dengue fever and severe dengue which should be suspected when a patient presents with abdominal pain and hypotension. Our case highlights the occurrence of splenic rupture in the viremic phase of dengue illness before the development of IgM antibodies.
Highlights
The spectrum of disease in dengue infection caused by four serotypes (DEN-1 to DEN-4) range from a subclinical or mild illness to a severe form of hemorrhagic fever which may prove fatal [1]
We report a non-fatal case of spontaneous splenic rupture in an adult patient with dengue fever with no cutaneous or mucosal bleeding tendencies but with features of circulatory collapse due to visceral bleed
Infections associated with Nontraumatic splenic rupture (NTSR) include infectious mononucleosis, malaria, typhoid, varicella, infective endocarditis, Q-fever, influenza, aspergillosis and dengue [14,16,17]
Summary
The spectrum of disease in dengue infection caused by four serotypes (DEN-1 to DEN-4) range from a subclinical or mild illness to a severe form of hemorrhagic fever which may prove fatal [1]. Introduction The spectrum of disease in dengue infection caused by four serotypes (DEN-1 to DEN-4) range from a subclinical or mild illness to a severe form of hemorrhagic fever which may prove fatal [1]. Acute abdominal pain is one of the atypical presentations of dengue fever, and spontaneous splenic rupture is a rare complication of dengue fever.
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