Acute pancreatitis complicating dengue hemorrhagic fever

Abstract Dengue infection can have spectrum of manifestations, often with an unpredictable clinical progression and outcome. There have been increasing reports of atypical manifestations. Abdominal pain or tenderness and persistent vomiting (warning signs) are present in the majority of cases with severe dengue prior to clinical deterioration. We report a 10-year-old child who presented with fever, persistent vomiting, and abdominal pain. A diagnosis of acute pancreatitis was made. This is a very infrequently reported complication of dengue hemorrhagic fever.

Unusual presentation of dengue fever

Dengue infection can present with varying clinical manifestations, which may not conform to the defi nitions of the World Health Organization [WHO] classifi cation. Flushing, puffi ness and cyanosis are some of the features, which are not included in the WHO criteria. Bleeding and thrombocytopenia are conspicuously absent in some children with "true" dengue hemorrhagic fever. Revised classifi cation based on dengue control study, in comparison with WHO classifi cation is defi nitely exclusive at detecting severe dengue infection. In fact fl ushing, puffi ness and cyanosis are not included in the past or recent WHO classifi cation criteria of dengue fever. It is practically feasible and facilitates realtime case management. All the classifi cations are only the guidelines and a good clinical acumen is an absolute necessity in diagnosing the criticality of the patient and prioritizing them for specifi c treatment