A Case of Dengue Presented with Pleural Effusion

Abstract

Dengue is caused by any one of four related viruses transmitted by mosquitoes. Dengue fever caused by the dengue virus (a Flavivirus), transmitted by female Aedes mosquito, remains a major global health concern, particularly in tropical and subtropical regions. It is a febrile illness, a disease of tropical areas, commonly encountered in India. Most of the infections are asymptomatic. The course of dengue infection varies from individual to individual and even in the same individual from time to time. The patient with dengue fever can present with a wide range of clinical manifestations from mild fever to life-threatening Dengue Shock Syndrome (DSS) and severe Dengue Hemorrhagic Fever (DHF). Pleuro- Pulmonary complications involve parenchymal infiltration, pleural effusion  (small, moderate, massive), pneumonitis, non-cardiogenic pulmonary oedema, hemorrhage-hemoptysis, and acute respiratory failure. A report of a case of a 55-year-old male who developed bilateral pleural effusion, pedal oedema, acute respiratory failure and who was semiconscious has been discussed in this case report. The dengue patient described in our case report presented with a typical history of fever with chills, myalgias with conjunctival redness and rash. He presented with features of plasma leakage namely pleural effusion, pedal oedema, ascites and hypotension. Thus, in conclusion, pulmonary complications in dengue coincide with plasma-leakage syndrome namely pleural effusion, infiltration, pneumonitis, acute respiratory failure, ARDS, and non-cardiogenic pulmonary oedema. Appropriate serum investigations with serial chest X-rays with thoracocentesis may help in early diagnosis and management.