Jayaweera D K, Subasinghe S, De Silva R F, Sanjeewa W A H P, Jayawickreme K P
Registrar in Medicine Ward 17 Sri Jayewardenepura General Hospital Sri Lanka, Sri Jayawardenepura Kotte, Sri Lanka.
Case Rep Infect Dis. 2021 Jan 13;2021:8854282. doi: 10.1155/2021/8854282. eCollection 2021.
Dengue is an arboviral infection that affects humanscausing significant morbidity and mortality in tropical countries. Our first patient who had diabetes presented with shock and was managed as dengue hemorrhagic fever with superadded sepsis which required noradrenalin plus broad-spectrum intravenous antibiotics. The second patient developed severe bradycardia during the ascending limb of the critical phase with hemodynamic stability, which recovered on discharge. Third patient presented with severe and rapid leaking; we used intravenous albumin as an alternative colloid with good outcome. The fourth patient was a pregnant mother at term, and she went into spontaneous labor during the latter half of the critical phase. The fifth patient developed dengue hemorrhagic fever complicated with probable haemophagocytic lymphohistiocytosis. She was treated with intravenous steroids andimmunoglobulin, yet succumbed on day 7. . Dengue is an extremely challenging and dynamic disease, which can lead to many unusual complications.A high index of suspicion is key to diagnose and treat promptly.
登革热是一种虫媒病毒感染，在热带国家会感染人类，导致严重的发病率和死亡率。我们的首例糖尿病患者出现休克，被诊断为登革出血热合并败血症，需要使用去甲肾上腺素和广谱静脉抗生素进行治疗。第二名患者在病程关键期的上升期出现严重心动过缓，但血流动力学稳定，出院时康复。第三名患者出现严重且迅速的渗漏；我们使用静脉注射白蛋白作为替代胶体，效果良好。第四名患者是一名足月孕妇，在病程关键期后半段出现自然分娩。第五名患者患登革出血热，可能合并噬血细胞性淋巴组织细胞增生症。她接受了静脉注射类固醇和免疫球蛋白治疗，但在第7天死亡。登革热是一种极具挑战性且变化多端的疾病，可导致许多不寻常的并发症。高度的怀疑指数是及时诊断和治疗的关键。
