Bhattacharjee, B.; Patel, H.B.; Karad, R.; Teja, V.; Mondal, A.; Haldar, S.N.; Saha, B. A Tropical Fever - Mimicking a Surgical Emergency. Preprints2023, 2023101004. https://doi.org/10.20944/preprints202310.1004.v1
APA Style
Bhattacharjee, B., Patel, H.B., Karad, R., Teja, V., Mondal, A., Haldar, S.N., & Saha, B. (2023). A Tropical Fever - Mimicking a Surgical Emergency. Preprints. https://doi.org/10.20944/preprints202310.1004.v1
Chicago/Turabian Style
Bhattacharjee, B., Soumendra Nath Haldar and Bibhuti Saha. 2023 "A Tropical Fever - Mimicking a Surgical Emergency" Preprints. https://doi.org/10.20944/preprints202310.1004.v1
Abstract
Introduction: Dengue is a mosquito transmitted arboviral infection. In dengue fever spontaneous bleeding in different parts of body occurs; but spontaneous bleeding into rectus muscle leading to haematoma formation is rare.
Case Presentation: A 72-year-old hypertensive female presented with high grade intermittent fever with chills and rigors for last four days. She was diagnosed to have dengue fever (NS1Ag -Reactive) on the day before admission. At admission, on examination she was found to be have dehydration. Immediately she was put on IV fluids, antiemetics and other supportive therapy. At admission she had low platelets, low haemoglobin, total leucocyte counts, with raised liver enzymes. On day 3 of illness, she had significant drop of haematocrit with low blood pressure and subsequently she managed with packed red blood cell (PRBC) transfusion. But on 9th day of illness, she has severe right iliac fossa pain mimicking acute appendicitis. CECT of abdomen showed soft tissue lesion in right lower abdomen (Inflammatory/ hematoma along rectus sheath) which was managed conservatively as per surgical opinion. 10 days past discharge she had no pain in right iliac fossa and size of hematoma was significantly reduced.
Discussion: In dengue fever, hematoma can be formed any vulnerable part in the but there are only a few cases reported to be having rectus sheath hematoma. Rectus sheath hematoma (RSH) has been mistaken for many acute abdominal diseases like- acute appendicitis. Our case mimicked acute appendicitis and managed conservatively with IV fluids, analgesics, Blood transfusion as it fits into RSH type II.
Conclusion: It is important to be vigilant in the patients who presents with abdominal pain in severe dengue cases. Prompt imaging in relevant areas could make the diagnosis and father treatment possible.
Copyright:
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
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