Gurung Shekhar, Karki Saurab, Khadka Manoj, Gurung Samanta, Dhakal Sandesh
Chattarapati Free Clinic Community Hospital, Kathmandu, Nepal.
Military Hospital Itahari, Sunsari, Nepal.
Ann Med Surg (Lond). 2022 Nov 17;84:104960. doi: 10.1016/j.amsu.2022.104960. eCollection 2022 Dec.
and importance: Although dengue fever classically presents with fever, headache, retro-orbital pain, myalgia, arthralgia, and vomiting, it can have unusual manifestations like acalculous cholecystitis. The study highlights the importance of atypical presentations of dengue fever in suspecting dengue earlier, especially during outbreaks.
Herein, we report a case of a 29 years old female who presented with fever for 5 days which was associated with headache, body ache, vomiting, and abdominal pain in the right hypochondriac region. Lab results came positive for dengue NS1 antigen, and ultrasonography showed features suggestive of acalculous cholecystitis. She was managed conservatively after which her symptoms resolved gradually.
Acute acalculous cholecystitis in dengue could be due to increased vascular permeability leading to edematous thickening of the gall bladder wall. It should be suspected if a patient presents with fever, right upper quadrant pain, abnormal liver function tests, and thickened gall bladder wall without stones on abdominal ultrasonography.
Acute acalculous cholecystitis is an atypical presentation of dengue fever. Awareness of atypical presentations of dengue helps in identifying dengue earlier and preventing complications.
及重要性:尽管登革热的典型症状为发热、头痛、眼眶后疼痛、肌痛、关节痛和呕吐,但它也可能有诸如无结石性胆囊炎等不寻常表现。该研究强调了登革热非典型表现对于早期怀疑登革热的重要性,尤其是在疫情暴发期间。
在此,我们报告一例29岁女性病例,该患者发热5天,伴有头痛、全身疼痛、呕吐以及右季肋区腹痛。实验室检查结果显示登革热NS1抗原呈阳性,超声检查显示有提示无结石性胆囊炎的特征。对她进行了保守治疗,之后其症状逐渐缓解。
登革热患者出现急性无结石性胆囊炎可能是由于血管通透性增加导致胆囊壁水肿增厚。如果患者出现发热、右上腹疼痛、肝功能检查异常以及腹部超声显示胆囊壁增厚但无结石,则应怀疑该病。
急性无结石性胆囊炎是登革热的一种非典型表现。了解登革热的非典型表现有助于早期识别登革热并预防并发症。