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

ABSTRACT

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.