Duodenal Perforation in a Patient with Dengue Fever –A Rare Entity
A 37-year-old gentleman presented to the emergency with a history of high-grade fever for 2 days and abdominal pain for one day. On arrival at the emergency department, he was hypotensive and tachycardic, while on abdominal examination he had generalized abdominal tenderness. He was started on fluid resuscitation with intravenous crystalloids. The initial impression was of an acute abdomen. The Abdominal X-ray showed air under the diaphragm. He was rushed to the operating room and underwent an emergency laparotomy that revealed a duodenal perforation for which he underwent Graham's patch repair and washout. No obvious cause was identified. He had low platelets for which Dengue NS-1 antigen was sent that came positive. Post-procedure he recovered and was discharged home. To our knowledge, this is the first case in which dengue fever associated with a duodenal perforation is being reported. It is the first case of gastrointestinal perforation in a patient with Dengue Fever to be reported outside of India. In endemic regions, clinicians must recognize such atypical manifestations.
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