Leukopenia And Thrombocytopenia In Dengue Fever: Common Laboratory Features Of Three Us Residents Traveling Abroad  

Abstract Category: Science
Course / Degree: case report
Institution / University: Montefiore Medical Center, United States
Published in: 2013

Report Abstract / Summary:

Background: Dengue fever (DF) is the most prevalent mosquito-borne viral illness; it is expected that over 50 million dengue virus infections occur each year worldwide. Dengue infection is a leading cause of mortality and morbidity in the tropics and subtropics. According to the latest data, DF has the potential to become established as an endemic disease in US.

Case presentation: This study includes clinical and laboratory findings of three returning travelers to New York, with a recent history of travel to the Caribbean, who were admitted to our hospital between August and October 2012.

The first case is a 53 year old female with PMH of hypertension, breast cancer, and recent travel to Honduras, who presents with fever, low back pain and generalized weakness. The only positive laboratory findings were thrombocytopenia and leukopenia. Our second case is a 45 year old female with PMH of breast cancer, nephrolithiasis and appendectomy, with a recent travel to Jamaica, who presents with fever, generalized weakness, nausea, vomiting and abdominal pain. The only positive laboratory data were thrombocytopenia, leukopenia and abnormal transaminases. The third case is a 55 year old female with PMH of TIA, asthma, hypertension, GERD and a recent travel to Jamaica, who presents with generalized weakness, diarrhea and dizziness. Positive laboratory data included abnormal LFTs, thrombocytopenia and leukopenia. In all of our three cases, serology testing was positive for Dengue fever. All the patients were acutely ill at the time of presentation.

Discussion: The classic presentation of DF (fever, headache, retroorbital pain, muscle and joint pains) may be absent in many patients, or may look just like other viral illnesses. In such scenarios laboratory data such as thrombocytopenia and leukopenia, and even abnormal LFTs in a returning traveler from an endemic area could play an important diagnostic role. Recognition of these laboratory features permits a rapid and early diagnosis, and may preclude the inappropriate use of antibiotics. Given the possibility of dengue becoming endemic in parts of the United States, the clinical and laboratory manifestations should be entrenched among internists.

CONCLUSION: Dengue fever should be highly considered in the differential diagnosis of thrombocytopenia and leukopenia in the returning traveler. Internists should be aware of these laboratory features in patients with associated clinical findings.

Report Keywords/Search Tags:
leukopenia,thrombocytopenia,dengue fever

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Submission Details: Report Abstract submitted by kourosh moshiri from United States on 25-Apr-2014 19:44.
Abstract has been viewed 2810 times (since 7 Mar 2010).

kourosh moshiri Contact Details: Email: drkmoshiri@yahoo.com

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