Dengue shock syndrome

Abstract

Dengue fever is a mosquito-borne arthropod-borne viral (arboviral) tropical disease in humans affecting 50-528 million people worldwide. The acute abdominal complications of dengue fever are acute appendicitis, acute pancreatitis, acute acalculous cholecystitis and non-specific peritonitis. Acute pancreatitis with new onset diabetes in dengue shock syndrome (DSS) is very rarely reported. We describe a case of 30-year-old man admitted in intensive care unit and was diagnosed with DSS with RT-PCR, NS1 antigen and dengue IgM antibody being positive. Abdominal ultrasound and computerized tomography confirmed acute pancreatitis. Patient required insulin after recovery. Diabetes mellitus caused by DSS is under-reported and lack of awareness may increase mortality and morbidity.

Figure 1:

Chest radiograph showing bilateral pleural effusion and alveolar infiltrates

Figure 2:

Normal 2D echocardiography of patient

Figure 3:

Ultrasound abdomen showing bulky and hypoechoic pancreas indicative of pancreatitis, fatty liver and ascites

Figure 4:

CT abdomen showing diffusely enlarged pancreas with scattered non enhancing areas suggestive of necrosis, extensive peripancreatic fat stranding, moderate ascites and bilateral pleural effusion