Viral hemorrhagic fever: an icu perspective

ABSTRACT

We present a series of 5 cases that were admitted to our intensive care unit [ICU] with suspicion of VHF. The first case was a 36 years surgeon, referred from Civil Hospital, Karachi to the emergency room [ER] AKUH. No previous history of comorbids existed. The presenting complaints were epigastric pain, vomiting and fever for 4 days, and shortness of breath for one day. He continued to deteriorate with severe acidosis, acute renal failure and bleeding diffusely. He was placed in isolation, cultures were taken and Ribavirin started. He remained in shock with escalating inotropic support and started bleeding from endotracheal tube and nose. He suffered a bradycardiac arrest with hypoxia and after a prolonged cardiopulmonary resuscitation [CPR], he expired. Microbiology showed Dengue IgM-negative, IgG positive by early spot, while Congo Crimean Hemorrhagic fever [CCHF] RNA was negative. History of exposure to VHF was possible as he had operated on a patient who had died suddenly without explanation. His concluding diagnosis was viral hemorrhagic fever