Pulmonary hemorrhage syndrome associated with an autochthonous case of dengue hemorrhagic fever.
Dengue fever is a major public health problem worldwide. Dengue hemorrhagic fever, a much rarer form of the disease, occurs when a person previously infected with dengue is re-infected with a different viral serotype. In recent years the infection rates of dengue and both clinical syndromes have increased along the United States-Mexico border. We present the case of a 61-year-old Laotian female who presented with a 1-week history of fever, altered mental status, oral ulceration, and rash. The patient developed diffuse pulmonary hemorrhage and anemia requiring multiple transfusions. She eventually sustained multi-organ system failure and expired. Both the titer data and serologies were consistent with the diagnosis of dengue hemorrhagic fever. We hypothesize that this syndrome was the result of re-infection occurring within the United States. This case is also unusual in that it is the second reported in the literature of pulmonary hemorrhages associated with dengue hemorrhagic fever.
Department of Internal Medicine, Brooke Army Medical Center, Fort Sam Houston, TX 78234, USA. Robert.Setlik@cen.amedd.army.mil
Robert F
RF
Setlik
Daniel
D
Ouellette
Julia
J
Morgan
C Kenneth
CK
McAllister
David
D
Dorsey
Brian K
BK
Agan
Lynn
L
Horvath
Michelle K
MK
Zimmerman
Bret
B
Purcell
D017809:Fatal Outcome; D005260:Female; D006470:Hemorrhage / Q000209:etiology*; D006801:Humans; D007812:Laos / Q000208:ethnology; D008171:Lung Diseases / Q000209:etiology*; D008875:Middle Aged; D012008:Recurrence; D019595:Severe Dengue / Q000150:complications*