Dengue hemorrhagic fever/ dengue shock syndrome in a patient with hereditary spherocytosis

BACKGROUND: Dengue Hemorrhagic Fever/Dengue Shock Syndrome (DHF/DSS) occurs only in a small number of dengue fever (DF).This condition,when coupled with a form of congenital hemolytic nemia called Hereditary Spherocytosis (HS), will turn a relatively manageable case of DF into a complicated condition with very poor prognosis. CASE PRESENTATION: Here we report a case of a 19-year-old male student from Manila who came in with fever,jaundice, and dengue warning signs. He was also diagnosed with HS. This compounding infection initiated a hemolytic crisis of his HS, causing severe bleeding and multiple organ failure on top of DHF/DSS. The progression of the disease started with bleeding, and later on with altered sensorium (encephalopathy), respiratory failure, and ultimately, demise. CONCLUSION: DHF/DSS together with HS may cause a hemolytic crisis. High RBC turnover and heightened erythroid marrow activity in HS makes a patient vulnerable to develop aplastic crisis due to dengue virus infection. Erythroid marrow failure may result in profound anemia, heart failure, hypoxia, cardiovascular collapse, and death.

Abnormal plasma cells in Philippine hemorrhagic fever

The hemorrhagic changes observed in 35 selected cases of Philippine hemorrhagic fever is described particularly the findings of abnormal plasma cells. The identification of this cell from other cellular elements of the peripheral blood is given. Correlations with the degree of leukopenia, onset of illness and abnormal platelets are made. The significance of this abnormal plasma cells in the diagnosis of the disease is emphasized.