Irwinda Rima, Wibowo Noroyono, Prameswari Natasya
Department of Obstetrics and Gynecology, Fetomaternal Division, Universitas Indonesia, Indonesia.
Department of Obstetrics and Gynecology, Universitas Indonesia, Indonesia.
IDCases. 2021;26:e01284. doi: 10.1016/j.idcr.2021.e01284. Epub 2021 Sep 6.
We report a 23-year-old pregnant woman who presented with acute high-grade fever, vomiting, and diarrhea for 5 days. She was first hospitalized in RSUD Tangerang-a secondary hospital based in Tangerang and were referred to Cipto Mangunkusumo General Hospital as a tertiary hospital. Initial laboratory results from previous hospital revealed leukopenia, low platelet, elevated aspartate transaminase, and alanine transaminase. Chest radiograph showed no pulmonary infiltration. Reverse transcriptase-PCR (RT-PCR) of the nasopharyngeal swab detected SARS-CoV-2, and NS1 antigen or IgM dengue-specific antibodies were positive. COVID-19 with dengue fever co-infection was diagnosed. Hemorrhagic manifestations were seen in both the mother (gum and gastrointestinal bleeding) and pregnancy (placental abruption). Patient was put on ventilator and was unfortunately lead to her death that were caused by multiorgan dysfunction failure due to co-infection of dengue and COVID-19. Both dengue and COVID-19 had similar manifestation, as it is a warning sign in pregnant patient experienced both that can lead to fatal result in mother and baby. Early diagnosis and management of co-infection is high clinical importance, especially in endemic area of dengue like Indonesia.
我们报告了一名23岁的孕妇，她出现急性高热、呕吐和腹泻5天。她最初在坦格朗地区医院（RSUD Tangerang，一家位于坦格朗的二级医院）住院，后被转诊至三级医院西托·曼古库苏莫综合医院（Cipto Mangunkusumo General Hospital）。前一家医院的初步实验室检查结果显示白细胞减少、血小板降低、天冬氨酸转氨酶和丙氨酸转氨酶升高。胸部X光片显示无肺部浸润。鼻咽拭子的逆转录聚合酶链反应（RT-PCR）检测到严重急性呼吸综合征冠状病毒2（SARS-CoV-2），NS1抗原或登革热特异性IgM抗体呈阳性。诊断为新冠肺炎合并登革热感染。母亲（牙龈和胃肠道出血）和妊娠（胎盘早剥）均出现出血表现。患者使用了呼吸机，但不幸的是，由于登革热和新冠肺炎合并感染导致多器官功能障碍衰竭，最终死亡。登革热和新冠肺炎有相似的表现，这对同时感染这两种疾病的孕妇来说是一个警示信号，可能导致母婴死亡。合并感染的早期诊断和管理具有高度的临床重要性，尤其是在印度尼西亚这样的登革热流行地区。
