Unmasking the mimic: when sepsis disguises as dengue shock syndrome

Authors

  • Anita Yadav Department of Obstetrics and Gynaecology, All India Institute of Medical Sciences (AIIMS), Nagpur, Maharashtra, India
  • Anusha Kamath Department of Obstetrics and Gynaecology, All India Institute of Medical Sciences (AIIMS), Nagpur, Maharashtra, India
  • Neha Gangane Department of Obstetrics and Gynaecology, All India Institute of Medical Sciences (AIIMS), Nagpur, Maharashtra, India
  • Amruta Abhijit Choudhary Department of Obstetrics and Gynaecology, All India Institute of Medical Sciences (AIIMS), Nagpur, Maharashtra, India
  • Avinash Prakash Department of Anaesthesiology, All India Institute of Medical Sciences (AIIMS), Nagpur, Maharashtra, India

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20240497

Keywords:

Dengue shock syndrome, Sepsis, Diagnostic challenges, Timely intervention, Comprehensive evaluation

Abstract

This case report delves into the diagnostic challenges faced when differentiating between sepsis and dengue shock syndrome (DSS), particularly in regions where both are endemic. A 23-year-old female initially diagnosed with DSS presented with fever, thrombocytopenia, and multi-organ dysfunction. Despite aggressive DSS management, the patient's condition worsened, prompting further investigation. Blood cultures eventually revealed Klebsiella pneumoniae, leading to a shift in diagnosis to sepsis. This case underscores the importance of comprehensive diagnostic evaluation, which included blood cultures, serological tests, and imaging. Prompt initiation of targeted antibiotics and comprehensive critical care resulted in significant improvement, highlighting the critical role of early recognition and intervention in optimizing outcomes. The complexities in distinguishing between sepsis and DSS underscore the need for continuous vigilance and a thorough diagnostic approach in similar clinical scenarios.

References

Devaraj NK, Ragubathi MN, Er SY, Ching SM. Septic shock as a differential diagnosis of severe dengue fever in a child in Malaysia - a Case Report. Mal J Med Health Sci. 2019;15(2):154-6.

Aguilar-Briseño JA, Moser J, Rodenhuis-Zybert IA. Understanding immunopathology of severe dengue: lessons learnt from sepsis. Curr Opin Virol. 2020;43: 41-9.

Kaukonen KM, Bailey M, Pilcher D. Systemic inflammatory response syndrome criteria in defining severe sepsis. N Engl J Med. 2015;372:1629-38.

Thiel SW, Rosini JM, Shannon W. Early prediction of septic shock in hospitalized patients. J Hosp Med. 2010;5:19-25.

Chandralekha, Gupta P, Trikha A. The north Indian dengue outbreak 2006: a retrospective analysis of intensive care unit admissions in a tertiary care hospital. Trans R Soc Trop Med Hyg. 2008;102:143-7.

Zhang Z, Smischney NJ, Zhang H, Van Poucke S, Tsirigotis P, Rello J, et al. AME evidence series 001-The Society for Translational Medicine: clinical practice guidelines for diagnosis and early identification of sepsis in the hospital. J Thorac Dis. 2016;8(9):2654-65.

Potts JA, Rothman AL. Clinical and laboratory features that distinguish dengue from other febrile illnesses in endemic populations. Trop Med Int Health. 2008; 13(11):1328-40.

Downloads

Published

2024-02-27

Issue

Section

Case Reports