Concomitant acute pulmonary embolism in recent dengue virus infection in an endemic country: case series
Abstract
Abstract Background There is a substantial gap in the understanding of dengue fever pathogenesis and pathophysiology concerning haemostatic equilibrium alteration. While haemorrhagic manifestation is common in dengue infection, the alteration towards venous thromboembolism (VTE) event is also known despite being infrequently reported. The VTE spectrum is composed of deep vein thrombosis (DVT) and pulmonary embolism (PE). Case summary We reported six cases in similar presentation of acute shortness of breath in the recent phase of dengue virus infection. All patients had increased serum D-dimer level with clinical criteria of pulmonary thromboembolism. Four of six patients had pulmonary thrombosis confirmation from pulmonary angiography computed tomography imaging. The patients were diagnosed with acute pulmonary thrombosis in the setting of recent dengue infection. Parenteral and oral anticoagulants were administered in all patients with favourable outcome in five patients but one patient died during admission. Discussion Haemorrhagic manifestation concern made the PE complication in dengue infection patients often overlooked. Significant clinical challenges arise upon the decision to treat PE pharmacologically in the clinical setting of haemorrhagic diathesis; anticoagulants in dengue are somewhat questionable and meet clinical dilemmas. Although PE is uncommonly described as a dengue complication, this may be an underlying mechanism in which well-known complication in…
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Evidence Hub reads this as a case series, done in people. Its evidence level is 5 of 5 (Very low · case / narrative / animal / in vitro / in silico). Case reports, narrative reviews, and animal, cell or computer-model studies give the weakest evidence for human health.
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