Dengue Hemorrhagic Fever Presenting with Acute Abdomen in aNon- Government Tertiary Care Hospital in Bangladesh

Abstract

A 60-year-old diabetic and hypertensive post-menopausal lady, presented at a tertiary care Hospital in Dhaka, Bangladesh with severe abdominal pain inthe right middle and lower abdomen, associated with oliguria for 1 day. She also gave history of having high grade fever and headache for 3 days, whichsubsided 2 days ago.
On examination, she was afebrile, mildly dehydrated, tachycardic (PR- 110/min), hypotensive (BP- 90/60 mm Hg), Tourniquet Test was positive. Herabdomen was tense and diffusely tender, especially in the right middle and lower parts, bowel sound was present, no organomegaly or lump was found.
S. Lipase was normal, Anti-dengue Antibody IgM and IgG were positive, CBC revealed Hemoglobin – 8.6 gm/dL, Hematocrit was raised- 52%, Plateletcount was 16000/ microliter, Stool for OBT was negative, RBS- 16 mmol/L and Urine RME and ketone bodies was negative.
A provisional diagnosis of Dengue Hemorrhagic fever with suspected intra- abdominal bleeding was made and she was shifted to ICU.