
Evidence of dengue virus replication in a non-traumatic spleen rupture case
2017; Springer Science+Business Media; Volume: 162; Issue: 11 Linguagem: Inglês
10.1007/s00705-017-3527-6
ISSN1432-8798
AutoresLuíz José de Souza, João de Azevedo, Liza Ingride Acha Kohler, Lorena de Freitas Barros, Mariana Arêdes Lima, Emiliana Mandarano Silva, Ronaldo Mohana‐Borges, Priscila Conrado Guerra Nunes, Marciano Viana Paes,
Tópico(s)Viral Infections and Outbreaks Research
ResumoThe 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.
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