Dear editor,
The recent report on “Dengue and brain hemorrhage” is very interesting11 Daher RT, Marussi VH, Pedroso JL, Oliveira AS, Amaral LL. Dengue virus
infection presenting with diffuse brain hemorrhage. Arq Neuropsiquiatr. 2014;72(10):815.
http://dx.doi.org/10.1590/0004-282X20140131
https://doi.org/10.1590/0004-282X2014013...
. Daher et al. reported an interesting case of diffuse brain
hemorrhage in a dengue patient11 Daher RT, Marussi VH, Pedroso JL, Oliveira AS, Amaral LL. Dengue virus
infection presenting with diffuse brain hemorrhage. Arq Neuropsiquiatr. 2014;72(10):815.
http://dx.doi.org/10.1590/0004-282X20140131
https://doi.org/10.1590/0004-282X2014013...
. In fact, the
brain hemorrhage in dengue is an interesting neurological complication of dengue. An
interesting namely expanded dengue syndrome should be discussed. This condition is an
extremely severe dengue presentation, it has the component of brain hemorrhage and other
unusual complications such as subacute thyroiditis22 Assir MZ, Jawa A, Ahmed HI. Expanded dengue syndrome: subacute thyroiditis
and intracerebral hemorrhage. BMC Infect Dis. 2012;12:240.
http://dx.doi.org/10.1186/1471-2334-12-240
https://doi.org/10.1186/1471-2334-12-240...
. The challenge in management of intracranial hemorrhage due to dengue
is the profound thrombocytopenia. The resolution of bleeding can be spontaneous in some
cases22 Assir MZ, Jawa A, Ahmed HI. Expanded dengue syndrome: subacute thyroiditis
and intracerebral hemorrhage. BMC Infect Dis. 2012;12:240.
http://dx.doi.org/10.1186/1471-2334-12-240
https://doi.org/10.1186/1471-2334-12-240...
. However, in the case with vital
site bleeding, the consideration of surgical management is needed. If there is no proper
management, the fatal outcome is common33 Wiwanitkit V. Magnitude and pattern of neurological pathology in fatal
dengue hemorrhagic fever: a summary of Thai cases. Neuropathology. 2005;25(4):398.
http://dx.doi.org/10.1111/j.1440-1789.2005.00653.x
https://doi.org/10.1111/j.1440-1789.2005...
. For
those cases, the use of platelet transfusion can be useful and the surgical managements
usually provide good outcome44 Kumar R, Prakash O, Sharma BS. Intracranial hemorrhage in dengue fever:
management and outcome: a series of 5 cases and review of literature. Surg Neurol.
2009;72(4):429-33. http://dx.doi.org/10.1016/j.surneu.2009.01.021
https://doi.org/10.1016/j.surneu.2009.01...
.
References
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1Daher RT, Marussi VH, Pedroso JL, Oliveira AS, Amaral LL. Dengue virus infection presenting with diffuse brain hemorrhage. Arq Neuropsiquiatr. 2014;72(10):815. http://dx.doi.org/10.1590/0004-282X20140131
» https://doi.org/10.1590/0004-282X20140131 -
2Assir MZ, Jawa A, Ahmed HI. Expanded dengue syndrome: subacute thyroiditis and intracerebral hemorrhage. BMC Infect Dis. 2012;12:240. http://dx.doi.org/10.1186/1471-2334-12-240
» https://doi.org/10.1186/1471-2334-12-240 -
3Wiwanitkit V. Magnitude and pattern of neurological pathology in fatal dengue hemorrhagic fever: a summary of Thai cases. Neuropathology. 2005;25(4):398. http://dx.doi.org/10.1111/j.1440-1789.2005.00653.x
» https://doi.org/10.1111/j.1440-1789.2005.00653.x -
4Kumar R, Prakash O, Sharma BS. Intracranial hemorrhage in dengue fever: management and outcome: a series of 5 cases and review of literature. Surg Neurol. 2009;72(4):429-33. http://dx.doi.org/10.1016/j.surneu.2009.01.021
» https://doi.org/10.1016/j.surneu.2009.01.021
Publication Dates
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Publication in this collection
Apr 2015
History
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Received
28 Oct 2014 -
Received
03 Dec 2014 -
Accepted
23 Dec 2014