Evidence of dengue virus replication in a non-traumatic spleen rupture case

The present report describes a case of splenic rupture due to dengue, a rare complication of dengue that should be considered in any patient with suspected dengue disease who started with left upper quadrant abdominal pain and hypotension. The pathophysiology of this entity is not yet well elucidate...

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Bibliographic Details
Published in:Archives of virology 2017-11, Vol.162 (11), p.3535-3539
Main Authors: de Souza, Luiz José, de Azevedo, João, Kohler, Liza Ingride Acha, Barros, Lorena de Freitas, Lima, Mariana Arêdes, Silva, Emiliana Mandarano, Mohana-Borges, Ronaldo, Nunes, Priscila Conrado Guerra, Paes, Marciano Viana
Format: Article
Language:English
Subjects:
Antigens
Atrophy
Biomedical and Life Sciences
Biomedicine
blood platelets
Brief Report
coagulation
dengue
Dengue - complications
Dengue fever
Dengue virus
Endothelial cells
Follicles
Hemorrhage
histopathology
Humans
Hypotension
Infectious Diseases
Macrophages
Male
Medical Microbiology
Mortality
Pain
pathophysiology
patients
Polymerase chain reaction
Replication
reverse transcriptase polymerase chain reaction
Rupture
serotypes
Spleen
Splenic Rupture - etiology
Splenic Rupture - pathology
Splenic Rupture - surgery
Virology
virus replication
Virus Replication - physiology
Young Adult
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Summary:The present report describes a case of splenic rupture due to dengue, a rare complication of dengue that should be considered in any patient with suspected dengue disease who started with left upper quadrant abdominal pain and hypotension. The pathophysiology of this entity is not yet well elucidated, but one of the theories present in the literature is that it is due to a depletion of coagulation factors and platelets leading to intra-splenic hemorrhage and rupture. The RT-PCR technique detected serotype 1 and histopathological studies of the spleen revealed significant atrophy of lymphoid follicles and extensive hemorrhage areas. Besides histopathological observations, virus replication was investigated by detection of dengue antigens, especially the non-structural 3 protein (NS3) in endothelial cells and splenic macrophages. This important complication has serious clinical repercussions and high mortality, due to the diagnostic difficulty and many factors that usually confuse or delay its diagnosis. Therefore, it is of the utmost importance to recognize their manifestations and their management to try to best minimize their consequences and mortality.
ISSN:0304-8608
1432-8798
DOI:10.1007/s00705-017-3527-6