Attached
Introduction
Despite the improvement in investigation techniques and updated management protocols,
dengue continues to bea killer in Sri Lanka. The reason for this is due to late presentations to
hospital, prescribing N S A ID by GPs, misdiagnosis, poor monitoring and mismanagement in
ward setup.
Case R eport
A previously-h^althy 10
year old boy presented with
a history o f high fever and
upper respiratory tract
infection for last 3 days.He
passed away 48 hours after
been admitted to
hospital.No external
orinternal features of
bleeding manifestations
were evident. Massive
cerebral oedema with 1.7kg
of brain weight, 600 ml o f
Straw coloured fluids in
plural cavity, 800ml of the
same type o f fluid in peritoneal cavity and flame shaped haemorrhages in endocardium were
evident. Ancillary reports were negative for H iN i, Leptospirosis and Dengue. Histology of
all organs was unremarkable. C SF -P C R was positive for Dengue.
i
Conclusion
Cause o f death was given as Dengue Shock Syndrome. Dengue antigen test which is
available in M R I can be done on day one in order toassist efficacious management.
