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Case Reports
. 2022;12(1):70.
doi: 10.1186/s43066-022-00233-9. Epub 2022 Dec 27.

A perfect storm: acute portal vein thrombosis in a patient with severe dengue and hemorrhagic manifestations-a case report

Affiliations
Case Reports

A perfect storm: acute portal vein thrombosis in a patient with severe dengue and hemorrhagic manifestations-a case report

Carlos Eduardo Ruiz Gonzalez et al. Egypt Liver J. 2022.

Abstract

Background: Dengue constitutes a public health problem in endemic regions. The clinical course can range from asymptomatic to severe expressions. Hemorrhagic manifestations are the most frequently reported complications; on the contrary, thrombotic complications are unusual.

Clinical case: We present the case of an adult patient who presented hemodynamic instability, severe thrombocytopenia, and positive serology for dengue, in whom acute portal vein thrombosis was documented. The possible pathophysiology of thrombocytopenia and thrombosis in dengue is discussed, as well as the dilemmas regarding the treatment of associated hemorrhagic and thrombotic manifestations.

Conclusions: The present case brings up the importance of considering the possibility of thrombotic events in patients with severe dengue. A high degree of suspicion, close assessment of hemostatic function, and quality supportive care are essential to improve outcomes. To our knowledge, this is the first report of dengue-associated portal vein thrombosis.

Keywords: Dengue; Portal vein thrombosis; Thrombocytopenia.

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Conflict of interest statement

Competing interestsThe authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Diagnostic Images performed. A Transthoracic echocardiogram showing the presence of bubbles in the right chambers (white arrow). B Contrast-enhanced abdominal tomography showing acute non-cirrhotic portal vein thrombosis: partial enhancement of the portal vein, showing an image compatible with a thrombus inside (white arrow)

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