A dengue infection without bleeding manifestations in an adult with immune thrombocytopenic purpura

Abstract

Background: Dengue is the most prevalent and fast spreading arboviral infection affecting people. No specific drug is available to treat dengue. Thrombocytopenia with potential of serious hemorrhages is one of the hall mark features of dengue. Immune thrombocytopenic purpura is an autoimmune disease causing thrombocytopenia. If a patient with that gets dengue, we expect severe thrombocytopenia with bleeding manifestations. Only a handful of such cases were reported before, and they were managed in different ways. Case presentation: A 30-year-old Sinhalese man recently diagnosed of immune thrombocytopenic purpura and on prednisolone was presented on the fourth day of fever, head ache, arthralgia, myalgia, and nausea. We started standard symptomatic dengue management and continued prednisolone. Dengue IgM and IgG antibody tests became positive. He was monitored by physical signs and serial full blood counts as the mainstay of monitoring. The patient never developed clinical bleeding manifestations and recovered. Conclusions: Considering the huge population at risk of dengue, generating more evidence on the topic and formulation of effective, simple guidelines to manage dengue in children and adults with immune thrombocytopenic purpura is going to be beneficial for many patients in the future.