Splenic rupture in dengue hemorrhagic fever: Report of a case and review

Abstract

Dengue is currently the most important arboviral disease in the world, particularly in tropical countries in which the environmental conditions favor the development and proliferation of the mosquito vector. Dengue hemorrhagic fever presents in two phases: an initial phase, which is characterized by sudden onset of fever and a variety of nonspecific signs and symptoms, and a critical phase, which is characterized by the recovery from fever and development of hemorrhagic symptoms and circulatory insufficiency. This report documents a case of splenic rupture in a patient with dengue hemorrhagic fever who developed hypovolemic shock and subsequently died. Although splenic rupture is a known complication of other acute infections, it is a rare complication of dengue; therefore, it may be misdiagnosed. In the case described here, the poor outcome mainly resulted from the sudden onset of complications; the patient died of splenic rupture less than 24 h after admission, and the cause of death was confirmed at necropsy.