title: Spontaneous splenic rupture in dengue fever with non-fatal outcome in an adult.
abstract: A 26-year-old male presented with fever for five days and abdominal pain for 24 hours. System examination identified a soft abdomen with diffuse tenderness. CT-abdomen findings were consistent with splenic rupture with intra and peri-splenic hematoma. Laboratory investigations showed a platelet count of 40,000 per mm(3). In due course he developed hypotension and underwent splenectomy. Non-structural protein 1 (NS1) dengue antigen was positive in the admission sample and IgM dengue antibodies were detected in the follow-up sample. Histopathology of the spleen showed normal architecture with no evidence of hyperplasia, cellular infiltrates or haematological malignancy. Splenic rupture is a rare, but potentially fatal complication of dengue fever and severe dengue which should be suspected when a patient presents with abdominal pain and hypotension. Our case highlights the occurrence of splenic rupture in the viremic phase of dengue illness before the development of IgM antibodies.
authors.affiliation: Sri Ramachandra Medical College and Research Institute, Porur, Chennai, India. drmeb1974@yahoo.co.in
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Bhaskar
authors.forename: Swathy
authors.initials: S
authors.lastname: Moorthy
mesh_terms: D015746:Abdominal Pain / Q000175:diagnosis / Q000209:etiology; D000328:Adult; D000914:Antibodies, Viral / Q000097:blood; D000956:Antigens, Viral / Q000097:blood; D003715:Dengue / Q000150:complications*; D006406:Hematoma / Q000175:diagnosis / Q000473:pathology; D006801:Humans; D007022:Hypotension / Q000175:diagnosis / Q000209:etiology; D007075:Immunoglobulin M / Q000097:blood; D008297:Male; D011860:Radiography, Abdominal; D013156:Splenectomy; D013161:Splenic Rupture / Q000150:complications / Q000175:diagnosis* / Q000473:pathology* / Q000601:surgery; D014057:Tomography, X-Ray Computed
chemical_list: D000914:Antibodies, Viral; D000956:Antigens, Viral; D007075:Immunoglobulin M