Bengal Physician Journal

Register      Login

VOLUME 8 , ISSUE 2 ( May-August, 2021 ) > List of Articles

CASE SERIES

Different Presentations of Expanded Dengue Syndrome: A Case Series and Review of Literature

Amitabha Saha, Tapas Bandyopadhyay, Madhusha Mukhopadhyay, Samiul Akhtar, Rohitaswa Mandal, Ankur Poddar, Sabbir Ahmed

Keywords : Acute kidney injury, Acute respiratory distress syndrome, Coagulopathy, Hemophagocytic lymphohistocytosis, Hypoxia, Myocarditis, Transverse myelitis

Citation Information : Saha A, Bandyopadhyay T, Mukhopadhyay M, Akhtar S, Mandal R, Poddar A, Ahmed S. Different Presentations of Expanded Dengue Syndrome: A Case Series and Review of Literature. Bengal Physician Journal 2021; 8 (2):52-56.

DOI: 10.5005/jp-journals-10070-7054

License: CC BY-NC 4.0

Published Online: 19-09-2021

Copyright Statement:  Copyright © 2021; The Author(s).


Abstract

Expanded dengue syndrome (EDS) is an atypical presentation of dengue fever with the involvement of various organ systems. We present five cases of EDS with varying features. The first and second patients had concurrent infection with falciparum malaria and vivax malaria, respectively, which made the diagnosis and treatment challenging. The third patient had coinfection with scrub typhus. The fourth patient was diagnosed with long-segment myelitis of the brain stem. The final patient in this series had a rare presentation consistent with post dengue hemophagocytic lymphohistocytosis (secondary HLH). There is no direct correlation between the severity of dengue and the type of organ involvement, and even without the classical features of dengue, serious complications can arise. In conclusion, it is of utmost importance to have a high index of suspicion and be well-informed of the different presentations and coinfections associated with EDS.


PDF Share
  1. Ranjit S, Kissoon N. Dengue hemorrhagic fever and shock syndromes. Pediatr Crit Care Med 2011;12(1):90–100. Review. DOI: 10.1097/PCC.0b013e3181e911a7.
  2. WHO Global Strategy for Dengue Prevention and Control 2012–2020 [cited 2020April 25]. Available from: https://apps.who.int/iris/bitstream/handle/10665/75303/9789241504034_eng.pdf;jsessionid=37F5E9BBDE1F440ECE29336BDCD13659?sequence=1.
  3. Dengue and severe dengue. [Cited 25April 2020] Available from: https://www.who.int/news-room/fact-sheets/detail/dengue-and-severe-dengue.
  4. Gulati S, Maheshwari A. Atypical manifestations of dengue. Trop Med Int Health 2007;12(9):1087–1095. DOI: 10.1111/j.1365-3156.2007.01891.x.
  5. Mohanty B, Sunder A, Pathak S. Clinicolaboratory profile of expanded dengue syndrome – Our experience in a teaching hospital. J Family Med Prim Care 2019;8(3):1022–1027. DOI: 10.4103/jfmpc.jfmpc_12_19.
  6. Lee LK, Gan VC, Lee VJ, et al. Clinical relevance and discriminatory value of elevated liver aminotransferase levels for dengue severity. PLoS Negl Trop Dis 2012;6(6):e1676. DOI: 10.1371/journal.pntd.0001676.
  7. Gonzalez-Fontal GR, Henao-Martinez AF. Dengue hemorrhagic fever complicated by pancreatitis. Braz J Infect Dis 2011;15(5):490–492. DOI: 10.1016/s1413-8670(11)70235-5.
  8. Sheetal S, Jacob E. A study on the cardiac manifestations of dengue. J Assoc Physicians India 2016;64(5):30–34.
  9. Koshy M, Mishra AK, Agrawal B, et al. Dengue fever complicated by hemophagocytosis. Oxf Med Case Reports. 2016;2016(6):121–124. DOI: 10.1093/omcr/omw043.
  10. Gavali AS, Shelgaonkar J, Bartakke S. Thrombotic thrombocytopenic purpura in a case of dengue fever: a rare presentation. Indian J Crit Care Med 2017;21(4):226–228. DOI: 10.4103/ijccm.IJCCM_27_16.
  11. Mohapatra MK, Patra P, Agrawala R. Manifestation and outcome of concurrent malaria and dengue infection. J Vector Borne Dis 2012;49(4):262–266.
  12. Sapkota S, Bhandari S, Sapkota S, et al. Dengue and scrub typhus coinfection in a patient presenting with febrile illness. Case Rep Infect Dis 2017;2017:6214083. DOI: 10.1155/2017/6214083.
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.