Cases reported "Dengue"

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1/82. A Japanese case of dengue fever with lymphocytic vasculitis: diagnosis by polymerase chain reaction.

    A 37-year-old Japanese male was admitted to Nagasaki University Hospital with abrupt onset of biphasic fever, general malaise and myalgia 9 days after coming back to japan from Manila. He developed a rubella like erythematous rash 3 days after admission and purpuric eruption one week after admission. A biopsied specimen from the purpura revealed lymphocytic vasculitis with T cell dominance and without immunoglobulin or complement deposition around the blood vessels. RT-PCR analysis on peripheral blood mononuclear cells using dengue virus specific primers confirmed the diagnosis of type 3 dengue fever. PCR analysis using virus specific primers is a rapid and valuable method for making a correct diagnosis of dengue fever.
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2/82. shock syndrome in primary dengue infections.

    During 1974, 114 patients with dengue hemorrhagic fever were studied at the Bankok Children's Hospital. Over 40% of the patients had dengue shock syndrome. Five fatal cases were included in the study. Primary dengue infections were identified by absent or low titered antibodies in acute sera and the sequential development of IgM antibodies followed by IgG antibodies during convalescence. Three patients, aged 4,8, and 12 years, had primary dengue infections with shock. Although no convalescent sera could be tested two other patients, aged 7 to 12 years, with fatal disease also appeared to have primary infections. At the time of shock patients with primary infections had subnormal concentrations of complement factor 3. The data show that in older children dengue shock syndrome associated with complement depression can occur during primary as well as secondary infections.
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3/82. The guillain-barre syndrome following dengue fever.

    A 44 year old female presented with fever, muscle aches, rash and a low platelet count. IgM antibody to dengue virus was positive. Two weeks later she developed a flaccid areflexic quadriparesis. Nerve conduction studies showed a predominantly demyelitinating sensory motor polyneuropathy consistent with guillain-barre syndrome. Despite the relatively common occurrence of dengue fever, an associated polyradiculoneuropathy is distinctly uncommon.
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4/82. Report of a fatal case of dengue infection with hepatitis: demonstration of dengue antigens in hepatocytes and liver apoptosis.

    A fatal case of dengue (DEN) infection associated with a spleen rupture and with hepatitis is reported here. Microscopic studies showed numerous areas of spleen rupture with hematomas and revealed necrotic foci in liver samples obtained at autopsy. Although hepatitis was reported in several cases of DEN fever, the mechanism of liver injury remains poorly understood. In this case, immunohistochemistry showed that DEN viral antigens were mostly detected in hepatocytes surrounding the necrotic foci. By in situ detection of dna fragmentation, apoptotic hepatocytes were found to be colocated with DEN virus-infected hepatocytes. These findings suggest that hepatocytes are the major sites of DEN virus replication in the liver and that DEN virus induces apoptosis of hepatocytes in vivo.
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5/82. Rapid diagnosis of primary dengue fever by the immunochromatographic test and by electron microscopy--a case report.

    A 21-year-old woman presented with an acute febrile illness after a two-week holiday in jamaica. Her symptoms started two days after return, with sudden onset of continuous high fever (> 39 degrees C), dizziness and nausea. Three days later she developed a generalized macular rash, which led to the tentative diagnosis "acute dengue fever." Laboratory confirmation was achieved by demonstrating anti-dengue IgM and IgG antibodies in paired sera; in addition, flavivirus particles were directly visualized by electron microscopy.
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6/82. A fever from the tropics.

    Shirley is a 42 year old woman who has rung you 5 days after returning from a 3 week resort holiday in malaysia and thailand. You saw her before her trip and administered a hepatitis a vaccine and advised her that she did not require anti malarial drugs as she was only going to large cities and beach resorts. She says she has had a high fever, headache and body aches for several days and that she feels exhausted, but is well enough to come to the surgery. When you see her later that morning, she looks fairly well, although she is moving rather gingerly. She says she has been resting, is drinking lots of fluids, has some anorexia, but no other significant symptoms. Examination reveals a temperature of 38 degrees C and she has a fine morbilliform rash on her body, limbs and neck. There are no other abnormal findings.
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7/82. Dengue infection with unusual manifestations: a case report.

    Since 1978, there has been an increasing number of reported cases of dengue infection with unusual manifestations and most of them had dengue shock syndrome. We report here one patient who had dengue hemorrhagic fever grade II with liver failure and hepatic encephalopathy and very high elevation of liver enzymes. She made a complete recovery after conservative therapy. She is the fourth case of reported dengue hemorrhagic fever grade II who had unusual manifestation.
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8/82. A case report: intracranial haemorrhage in a patient with probable dengue fever.

    We present a rare case of a patient diagnosed with probable dengue fever sustaining an intracranial haemorrhage after a trivial motor vehicle accident. From the literature reviewed, it was noted that there have been no reports of dengue fever presenting with an intracranial haemorrhage, and the association is more common in patients diagnosed with dengue hemorrhagic fever and/or dengue shock syndrome.
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9/82. Acute parotitis due to dengue virus.

    Acute bilateral parotitis is a common clinical feature of various infectious and autoimmune, metabolic, and drug-related conditions. We describe a unique case of bilateral inflammatory enlargement of the parotid glands in an immunocompetent patient with dengue fever. Evidence of dengue virus in the saliva is also provided for the first time.
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10/82. Unusual association of Kikuchi's disease and dengue virus infection evolving into systemic lupus erythematosus.

    Kikuchi's disease is a histologically alarming self-limiting condition typically affecting the lymph nodes of young females. A 13-year-old girl was presented with fever, skin rash and cervical lymphadenopathy. On examination she was found febrile, mild pallor was present and she had lymphadenopathy. Liver was palpable. Cervical lymph node biopsy showed histiocytic necrotising lymphadenitis (Kikuchi's disease). dengue virus serology for IgG blot showed evidence of seroconversion in serial samples. She was treated with antibiotics and fluconazole and cyclosporin A. During hospitalisation she developed retinal vasculitis. She was reviewed after one month and showed rashes of subacute cutaneous lupus erythematosus. This case can be described to be a triggering event by dengue viral infection causing abnormal immune response leading initially to Kikuchi's disease and later on to systemic lupus erythematosus.
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