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Fulminant liver failure secondary to haemorrhagic dengue in an international traveller
Author(s) -
Gasperino James,
Yunen Jose,
Guh Alice,
Tanaka Kathryn E.,
Kvetan Vladimir,
Doyle Howard
Publication year - 2007
Publication title -
liver international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.873
H-Index - 110
eISSN - 1478-3231
pISSN - 1478-3223
DOI - 10.1111/j.1478-3231.2007.01543.x
Subject(s) - dengue fever , dengue virus , medicine , fulminant hepatic failure , jaundice , serotype , fulminant , disseminated intravascular coagulation , septic shock , shock (circulatory) , intensive care medicine , virology , immunology , sepsis , pediatrics , liver transplantation , transplantation
Dengue infections are caused by a single‐stranded RNA virus, which has four serotypes (DEN 1–4); mosquitoes of the genus Aedes serve as vectors of transmission. Risk factors for dengue infection are related to both the host and virus. Age, gender, immune status, and genetic background of the host all contribute to the severity of dengue infection. Recently, international travel to endemic areas has also been identified as a major risk factor for both primary and secondary dengue infection. Dengue remains a diagnostic challenge, given its protean nature, ranging from mild febrile illness to profound shock. The most severe manifestation of dengue infection is dengue shock syndrome, which has an estimated mortality rate close to 50%. Dengue shock syndrome typically presents with increased anion gap metabolic acidosis, disseminated intravascular coagulation, severe hypotension, and jaundice. Liver involvement appears to occur more frequently when infections involve DEN‐3 and DEN‐4 serotypes. While hepatocellular damage has been reported previously in dengue infection, acute liver failure is an extremely rare occurrence in adults. We report a patient with dengue shock syndrome who presented with acute liver failure and hepatic encephalopathy after recent travel to an endemic area.