Spontaneous spinal intradural hemorrhage in dengue fever: a case report
Abstract Background Spontaneous spinal cord hemorrhage is extremely rare in dengue fever. We report a case of spontaneous spinal intradural hemorrhage in dengue fever associated with severe thrombocytopenia. Case presentation A 48-year-old Indian woman presented with fever and body aches followed by...
| Main Authors: | , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2022-05-01
|
| Series: | Journal of Medical Case Reports |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s13256-022-03451-2 |
| _version_ | 1828328795091763200 |
|---|---|
| author | Rajeev Mohan Kaushik Ranjit Kumar Madhurima Kaushik Manju Saini Reshma Kaushik |
| author_facet | Rajeev Mohan Kaushik Ranjit Kumar Madhurima Kaushik Manju Saini Reshma Kaushik |
| author_sort | Rajeev Mohan Kaushik |
| collection | DOAJ |
| description | Abstract Background Spontaneous spinal cord hemorrhage is extremely rare in dengue fever. We report a case of spontaneous spinal intradural hemorrhage in dengue fever associated with severe thrombocytopenia. Case presentation A 48-year-old Indian woman presented with fever and body aches followed by acute onset of paraplegia with bladder and bowel dysfunction and loss of sensations below the level of the umbilicus. She had severe thrombocytopenia and positive dengue serology. Magnetic resonance imaging of the spine showed compression of the spinal cord due to intradural hematoma at the D7–D8 vertebral level. The patient received symptomatic treatment for dengue fever and steroids. Emergency D7–D8 laminectomy with excision of the clot and dural repair was done after stabilizing the platelet count with multiple platelet transfusions. The constitutional symptoms responded well to the treatment. There was good improvement in sensory symptoms but negligible improvement in paraplegia with a change in muscle power from grade 0/5 to grade 1/5 in the postoperative period. The patient was discharged from the hospital in a stable condition, but paraplegia showed little improvement during follow-up of 1 year. Conclusions Spontaneous spinal cord hemorrhage can present as acute paraplegia in dengue fever. Failure to recognize this complication can delay initiating appropriate treatment with permanent loss of neurologic function. |
| first_indexed | 2024-04-13T20:15:02Z |
| format | Article |
| id | doaj.art-e2e9164c8a364e32a3ded4d0606d8343 |
| institution | Directory Open Access Journal |
| issn | 1752-1947 |
| language | English |
| last_indexed | 2024-04-13T20:15:02Z |
| publishDate | 2022-05-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of Medical Case Reports |
| spelling | doaj.art-e2e9164c8a364e32a3ded4d0606d83432022-12-22T02:31:44ZengBMCJournal of Medical Case Reports1752-19472022-05-011611410.1186/s13256-022-03451-2Spontaneous spinal intradural hemorrhage in dengue fever: a case reportRajeev Mohan Kaushik0Ranjit Kumar1Madhurima Kaushik2Manju Saini3Reshma Kaushik4Department of General Medicine, Himalayan Institute of Medical Sciences, Swami Rama Himalayan UniversityDepartment of Neurosurgery, Himalayan Institute of Medical Sciences, Swami Rama Himalayan UniversityDepartment of Ophthalmology, Himalayan Institute of Medical Sciences, Swami Rama Himalayan UniversityDepartment of Radiodiagnosis, Himalayan Institute of Medical Sciences, Swami Rama Himalayan UniversityDepartment of General Medicine, Himalayan Institute of Medical Sciences, Swami Rama Himalayan UniversityAbstract Background Spontaneous spinal cord hemorrhage is extremely rare in dengue fever. We report a case of spontaneous spinal intradural hemorrhage in dengue fever associated with severe thrombocytopenia. Case presentation A 48-year-old Indian woman presented with fever and body aches followed by acute onset of paraplegia with bladder and bowel dysfunction and loss of sensations below the level of the umbilicus. She had severe thrombocytopenia and positive dengue serology. Magnetic resonance imaging of the spine showed compression of the spinal cord due to intradural hematoma at the D7–D8 vertebral level. The patient received symptomatic treatment for dengue fever and steroids. Emergency D7–D8 laminectomy with excision of the clot and dural repair was done after stabilizing the platelet count with multiple platelet transfusions. The constitutional symptoms responded well to the treatment. There was good improvement in sensory symptoms but negligible improvement in paraplegia with a change in muscle power from grade 0/5 to grade 1/5 in the postoperative period. The patient was discharged from the hospital in a stable condition, but paraplegia showed little improvement during follow-up of 1 year. Conclusions Spontaneous spinal cord hemorrhage can present as acute paraplegia in dengue fever. Failure to recognize this complication can delay initiating appropriate treatment with permanent loss of neurologic function.https://doi.org/10.1186/s13256-022-03451-2DengueParaplegiaSpinal intradural hemorrhageThrombocytopenia |
| spellingShingle | Rajeev Mohan Kaushik Ranjit Kumar Madhurima Kaushik Manju Saini Reshma Kaushik Spontaneous spinal intradural hemorrhage in dengue fever: a case report Journal of Medical Case Reports Dengue Paraplegia Spinal intradural hemorrhage Thrombocytopenia |
| title | Spontaneous spinal intradural hemorrhage in dengue fever: a case report |
| title_full | Spontaneous spinal intradural hemorrhage in dengue fever: a case report |
| title_fullStr | Spontaneous spinal intradural hemorrhage in dengue fever: a case report |
| title_full_unstemmed | Spontaneous spinal intradural hemorrhage in dengue fever: a case report |
| title_short | Spontaneous spinal intradural hemorrhage in dengue fever: a case report |
| title_sort | spontaneous spinal intradural hemorrhage in dengue fever a case report |
| topic | Dengue Paraplegia Spinal intradural hemorrhage Thrombocytopenia |
| url | https://doi.org/10.1186/s13256-022-03451-2 |
| work_keys_str_mv | AT rajeevmohankaushik spontaneousspinalintraduralhemorrhageindenguefeveracasereport AT ranjitkumar spontaneousspinalintraduralhemorrhageindenguefeveracasereport AT madhurimakaushik spontaneousspinalintraduralhemorrhageindenguefeveracasereport AT manjusaini spontaneousspinalintraduralhemorrhageindenguefeveracasereport AT reshmakaushik spontaneousspinalintraduralhemorrhageindenguefeveracasereport |