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以心包积液和心脏压塞为表现的登革出血热:一例报告

Dengue Hemorrhagic Fever Presenting With Pericardial Effusion and Cardiac Tamponade: A Case Report.

作者信息

Parepalli Avinash, Saboo Keyur, Acharya Sourya, Kota Vijay, Nelakuditi Manikanta

机构信息

Department of Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND.

出版信息

Cureus. 2025 Jan 3;17(1):e76836. doi: 10.7759/cureus.76836. eCollection 2025 Jan.

Abstract

Dengue fever encompasses a spectrum of illnesses, ranging from mild dengue fever to more severe forms, including dengue hemorrhagic fever (DHF) and dengue shock syndrome (DSS). Cardiogenic shock and multi-organ failure are among the complications that can arise from the syndrome, which is considered to be caused by endothelial cell loss and increased capillary permeability. Its incidence is especially significant during monsoon seasons. A 45-year-old woman required intubation after presenting with hypotension and changed mental status after suffering from a high-grade fever, severe headache, myalgias, and progressive respiratory distress for seven days. An emergency was called when imaging indicated a considerable pericardial effusion, which echocardiography verified. Pericardiocentesis was carried out, and 300 mL of hemorrhagic fluid was collected. She then required inotropic therapy to avoid cardiogenic shock. After receiving empirical antibiotics, platelet transfusions, and close supervision, the patient's health improved, and the pericardial drain was removed on the fifth day of hospitalization. Since myocarditis and pericardial effusion are uncommon but hazardous cardiac symptoms in dengue fever, it is critical to detect and treat these disorders in patients with severe dengue fever to limit the illness's morbidity and mortality.

摘要

登革热包括一系列疾病,从轻度登革热到更严重的形式,包括登革出血热(DHF)和登革休克综合征(DSS)。心源性休克和多器官衰竭是该综合征可能出现的并发症,该综合征被认为是由内皮细胞丢失和毛细血管通透性增加引起的。其发病率在季风季节尤为显著。一名45岁女性在高热、严重头痛、肌痛和进行性呼吸窘迫7天后出现低血压和精神状态改变,随后需要插管。影像学检查显示有大量心包积液,经超声心动图证实后呼叫了急救。进行了心包穿刺术,收集到300毫升血性液体。然后她需要进行强心治疗以避免心源性休克。在接受经验性抗生素治疗、输注血小板并密切监测后,患者病情好转,住院第五天拔除了心包引流管。由于心肌炎和心包积液在登革热中虽不常见但却是危险的心脏症状,因此对于重症登革热患者,检测和治疗这些病症以限制疾病的发病率和死亡率至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b1ad/11787622/6de6af4ec24e/cureus-0017-00000076836-i01.jpg

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Cardiac tamponade in a patient with severe dengue fever.一名重症登革热患者出现心脏压塞。
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