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Jayarajah U, Lahiru M, De Zoysa I, Seneviratne SL. Dengue Infections and the Surgical Patient. Am J Trop Med Hyg 2021; 104:52-59. [PMID: 33200725 DOI: 10.4269/ajtmh.20-0983] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
Dengue infections are increasing globally and account for significant morbidity and mortality. Severe dengue results in microvascular changes and coagulopathy that may make surgical intervention risky and the overall surgical management challenging. We outline the potential surgical manifestations and complications following dengue infections and describe the clinical, pathogenetic, diagnostic, and treatment aspects of dengue and surgical patients. The main surgical presentations were acute cholecystitis, acute pancreatitis, acute appendicitis, splenic rupture, bowel perforation, gastrointestinal bleeding, and hematomas. Dengue may also mimic an acute abdomen without any true surgical complications. A majority were treated nonoperatively. Misdiagnosis and unnecessary surgical intervention resulted in poor outcomes. Better knowledge of the potential surgical complications would help in early diagnosis, treatment, and referral to specialized centers and thus improve outcomes. A high degree of suspicion of dengue fever is necessary when patients in a dengue-epidemic area present with acute abdomen or bleeding manifestations. In endemic areas, early dengue antigen testing and abdominal imaging before surgical intervention may help in the diagnoses. Multidisciplinary team involvement with case-by-case decision-making is needed for optimal care.
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Affiliation(s)
- Umesh Jayarajah
- 1Department of Surgery, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka
| | - Malintha Lahiru
- 2Faculty of Medicine, University of Colombo, Colombo, Sri Lanka
| | - Ishan De Zoysa
- 1Department of Surgery, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka
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Jayasundara B, Perera L, de Silva A. Dengue fever may mislead the surgeons when it presents as an acute abdomen. ASIAN PAC J TROP MED 2016; 10:15-19. [PMID: 28107859 DOI: 10.1016/j.apjtm.2016.12.010] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2016] [Revised: 11/18/2016] [Accepted: 12/17/2016] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE To review the management experience of a consecutive series of patients presenting as acute surgical abdomen whom were ultimately diagnosed to have DF (Dengue fever)/DHF (Dengue hemorrhagic fever). METHODS Clinical data of all cases of apparent acute abdomen (AA) which were later confirmed as having DF/DHF reviewed by two surgical units from December 2012 to December 2013 were analyzed. Initially confirmed patients with DF/DHF who developed abdominal symptoms were not considered. RESULTS Out of the seventeen cases (7 males, age range 10-71 years) presented with fever and AA; appendicitis, cholecystitis, pancreatitis and non-specific peritonitis were suspected initially in 8, 5, 1 and 3 cases, respectively. Neutropenia or thrombocytopenia signifying DF/DHF occurred only in 11 patients at first evaluation thus six remained as surgical candidates beyond 24 h. One patient underwent appendicectomy with a prolonged hospital stay. DF was confirmed by serology in all patients, latest by fourth day of admission. One required blood product transfusion, 4 needed critical care treatment and there was 1 death. CONCLUSIONS DF/DHF misleads the clinicians when it presents as AA. Initial hematological and ultrasonographic findings may be equivocal creating a diagnostic and management dilemma. Vigilant clinical suspicion and early dengue serological assessment is advisable in equivocal cases of AAs with fever in dengue endemic areas, to confirm/exclude the infection in order to avoid unnecessary surgical morbidity in the presence of DF.
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Affiliation(s)
- Bingumal Jayasundara
- Department of General Surgery, National Hospital of Sri Lanka, Colombo 10, Sri Lanka; Department of General Surgery, Colombo South Teaching Hospital, Kalubowila, Sri Lanka.
| | - Lalith Perera
- Department of General Surgery, National Hospital of Sri Lanka, Colombo 10, Sri Lanka; Department of General Surgery, Colombo South Teaching Hospital, Kalubowila, Sri Lanka
| | - Ajith de Silva
- Department of General Surgery, National Hospital of Sri Lanka, Colombo 10, Sri Lanka
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Je S, Bae W, Kim J, Seok SH, Hwang ES. Epidemiological Characteristics and Risk Factors of Dengue Infection in Korean Travelers. J Korean Med Sci 2016; 31:1863-1873. [PMID: 27822922 PMCID: PMC5102847 DOI: 10.3346/jkms.2016.31.12.1863] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2016] [Accepted: 10/07/2016] [Indexed: 01/25/2023] Open
Abstract
Dengue viral infection has rapidly spread around the world in recent decades. In Korea, autochthonous cases of dengue fever have not been confirmed yet. However, imported dengue cases have been increased since 2001. The risk of developing severe dengue in Korean has been increased by the accumulation of past-infected persons with residual antibodies to dengue virus and the remarkable growth of traveling to endemic countries in Southeast Asia. Notably, most of imported dengue cases were identified from July to December, suggesting that traveling during rainy season of Southeast Asia is considered a risk factor for dengue infection. Analyzing national surveillance data from 2011 to 2015, males aged 20-29 years are considered as the highest risk group. But considering the age and gender distribution of travelers, age groups 10-49 except 20-29 years old males have similar risks for infection. To minimize a risk of dengue fever and severe dengue, travelers should consider regional and seasonal dengue situation. It is recommended to prevent from mosquito bites or to abstain from repetitive visit to endemic countries. In addition, more active surveillance system and monitoring the prevalence asymptomatic infection and virus serotypes are required to prevent severe dengue and indigenous dengue outbreak.
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Affiliation(s)
- Sungmo Je
- Department of Microbiology and Immunology, Seoul National University College of Medicine, Seoul, Korea
- Global Center for Infectious Diseases, Seoul National University College of Medicine, Seoul, Korea
- Institute of Endemic Diseases, Seoul National University Medical Research Center, Seoul, Korea
| | - Wonjun Bae
- Department of Microbiology and Immunology, Seoul National University College of Medicine, Seoul, Korea
- Global Center for Infectious Diseases, Seoul National University College of Medicine, Seoul, Korea
- Institute of Endemic Diseases, Seoul National University Medical Research Center, Seoul, Korea
| | - Jiyeon Kim
- Department of Microbiology and Immunology, Seoul National University College of Medicine, Seoul, Korea
- Global Center for Infectious Diseases, Seoul National University College of Medicine, Seoul, Korea
- Institute of Endemic Diseases, Seoul National University Medical Research Center, Seoul, Korea
| | - Seung Hyeok Seok
- Department of Microbiology and Immunology, Seoul National University College of Medicine, Seoul, Korea
- Global Center for Infectious Diseases, Seoul National University College of Medicine, Seoul, Korea
- Institute of Endemic Diseases, Seoul National University Medical Research Center, Seoul, Korea
| | - Eung Soo Hwang
- Department of Microbiology and Immunology, Seoul National University College of Medicine, Seoul, Korea
- Global Center for Infectious Diseases, Seoul National University College of Medicine, Seoul, Korea
- Institute of Endemic Diseases, Seoul National University Medical Research Center, Seoul, Korea.
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Nam KW, Kim JE, Doo EY, Jung HM, Lee ES, Kim BS, Park JH, Min JY, Ko MK, Pai HJ. A Case of Dengue Fever with Maculopathy. Infect Chemother 2012. [DOI: 10.3947/ic.2012.44.6.504] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Affiliation(s)
- Kil Woo Nam
- Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea
| | - Jee Eun Kim
- Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea
| | - Eun Young Doo
- Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea
| | - Hye Mi Jung
- Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea
| | - Eun Sung Lee
- Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea
| | - Bo Sang Kim
- Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea
| | - Ji Hoon Park
- Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea
| | - Ji Yeon Min
- Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea
| | - Myung Kyoo Ko
- Department of Ophthalmology, Hanyang University College of Medicine, Seoul, Korea
| | - Hyun Joo Pai
- Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea
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Kim MJ, Oh DH, Oh IM, Yoo KH, Im SG, Jang SK, Jeon DO, Cho HJ, Lee SJ, Ghil HK, Lee SG, Kim SY. A Case of Dengue Fever Complicated by Retinitis. Infect Chemother 2012. [DOI: 10.3947/ic.2012.44.4.307] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Affiliation(s)
- Mi-Jeoung Kim
- Department of Internal Medicine, Bundang Jesaeng General Hospital, Seongnam, Korea
| | - Dong-Hyun Oh
- Department of Internal Medicine, Bundang Jesaeng General Hospital, Seongnam, Korea
| | - In-Myung Oh
- Department of Internal Medicine, Bundang Jesaeng General Hospital, Seongnam, Korea
| | - Kyoung-Hwa Yoo
- Department of Internal Medicine, Bundang Jesaeng General Hospital, Seongnam, Korea
| | - Sung-Gyu Im
- Department of Internal Medicine, Bundang Jesaeng General Hospital, Seongnam, Korea
| | - Sun-Kyung Jang
- Department of Internal Medicine, Bundang Jesaeng General Hospital, Seongnam, Korea
| | - Dong-Ok Jeon
- Department of Internal Medicine, Bundang Jesaeng General Hospital, Seongnam, Korea
| | - Hyo-Jin Cho
- Department of Internal Medicine, Bundang Jesaeng General Hospital, Seongnam, Korea
| | - Sang-Jin Lee
- Department of Internal Medicine, Bundang Jesaeng General Hospital, Seongnam, Korea
| | - Hyun-Kyung Ghil
- Department of Ophthalmology, Bundang Jesaeng General Hospital, Seongnam, Korea
| | - Seong-Gyu Lee
- Department of Laboratory Medicine, Bundang Jesaeng General Hospital, Seongnam, Korea
| | - Sue-Yun Kim
- Department of Internal Medicine, Bundang Jesaeng General Hospital, Seongnam, Korea
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