Difficulty in diagnosis and treatment of dengue hemorrhagic fever in patients with chronic renal failure: report of three cases of mortality.
In 2002, an outbreak of dengue fever (DF) in Taiwan caused mortality in some patients with chronic renal failure (CRF). We report three cases of CRF who died of dengue hemorrhagic fever (DHF) and dengue shock syndrome (DSS) despite an intensive care process. The difficulty in diagnosis and the treatment dilemma attributable to ambiguity in symptoms and signs between CRF and DF may delay the diagnosis, contributing to a high risk of mortality. The narrow window of fluid tolerance in patients with CRF further hampers the success of resuscitation in DHF and DSS. Continuous venous to venous hemodialysis (CVVHD) is helpful in managing a condition with unstable hemodynamics. However, to decrease mortality, the physician must pay great attention to ensure an early awareness of DHF/DSS and deliver a prompt and aggressive treatment of patients of dengue viral infections with chronic renal failure.
Kuo
Mei-Chuan
MC
Division of Nephrology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.
Chang
Jer-Ming
JM
Lu
Po-Liang
PL
Chiu
Yi-Wen
YW
Chen
Hung-Chun
HC
Hwang
Shang-Jyh
SJ
D000368:Aged; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications*; D008297:Male; D008875:Middle Aged; D019595:Severe Dengue / Q000150:complications* / Q000175:diagnosis* / Q000628:therapy