A 26-year-old postpartum female presented with symptoms characteristic of dengue fever on the 16th day of puerperium. On the third day of the illness, the patient presented a clinical picture consistent with shock. Tests determined primary infection with dengue virus serotype 2. Cardiac tamponade was confirmed by echocardiography. This rare manifestation is described in a patient without any associated comorbidity.
Keywords:
Dengue; Severe dengue; Cardiac tamponade
| Exam | RV | BA | At admission | Days after admission | ||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1 | 3 | 4 | 5 | 6 | 7 | 8 | 10 | 14 | ||||
| CBC | ||||||||||||
| Hemoglobin | 12 - 16g/dL | 15.6 | 8.4 | 15.7 | 12.2 | 10.6 | 11 | 11.2 | 10.5 | 10.6 | 12.3 | 10.3 |
| Hematocrit | 4 - 5.2 millions/mm3 | 44.8 | 25.1 | 46.3 | 36.6 | 31.9 | 33.8 | 34,2 | 32 | 32,6 | 38,1 | 31 |
| Leukocyte (x1,000) | 4.2 - 11.0/mm3 | 3.7 | 4.4 | 10.8 | 8.0 | 9.0 | 10.4 | 11.3 | 7.9 | 8.7 | 10.8 | 7.7 |
| Neutrophils | 40 - 70% | 70 | 65 | 70 | 83 | 80 | 82 | 78 | 79 | 76 | 69 | 69 |
| Rods | 0 - 5% | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| Platelets (x1,000) | 150 - 450 thousand/mm3 | 169 | 115 | 133 | 170 | 203 | 316 | 304 | 287 | 239 | 324 | 323 |
| Coagulation | ||||||||||||
| APTT | 10 - 14 | 10.2 | 10.2 | 10.2 | 10.2 | 10.4 | - | - | - | 11,3 | - | |
| PTT | 100% | 100 | 100 | 100 | 100 | 97 | - | - | - | 84 | - | |
| Biochemistry | ||||||||||||
| AST | 11 - 39U/L | 29 | 38 | - | - | 261 | - | - | - | - | 83 | |
| ALT | 11 - 45U/L | 35 | 26 | - | - | 143 | - | - | - | - | 162 | |
| Albumin | 3.5 - 5.5g/dL | 1 | - | - | 1.8 | - | - | - | - | 5.2 | ||
| C-reactive protein | <5mg/L | 6.4 | - | - | - | - | - | - | - | 87.2 | ||
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