Annals of Tropical Medicine and Public Health

LETTER TO THE EDITOR
Year
: 2013  |  Volume : 6  |  Issue : 2  |  Page : 265-

Menstruation during dengue hemorrhagic fever: A case study


Viroj Wiwanitkit 
 Hainan Medical University, China, Faculty of Medicine, University of Nis, Serbia, Joseph Ayobabalola University, Nigeria

Correspondence Address:
Viroj Wiwanitkit
Wiwantikit House, Bangkhae, Bangkok - 10160, Thailand




How to cite this article:
Wiwanitkit V. Menstruation during dengue hemorrhagic fever: A case study.Ann Trop Med Public Health 2013;6:265-265


How to cite this URL:
Wiwanitkit V. Menstruation during dengue hemorrhagic fever: A case study. Ann Trop Med Public Health [serial online] 2013 [cited 2019 Sep 16 ];6:265-265
Available from: http://www.atmph.org/text.asp?2013/6/2/265/116518


Full Text

Sir,

Dengue is an important mosquito borne infection that is still a public health threat in many tropical developing countries. Its classical clinical presentation as acute febrile illness accompanied with hemorrhagic complications is known, nevertheless, it sometimes can be serious and fatal. A case study of a 35-year-old female with no underlying disease is reported; she was diagnosed to have dengue (confirmed by laboratory test, at diagnosis: platelet = 80,000/mm 3 ,

hematocrit = 44%, stable vital sign) for past 3 days and, therefore, received conservative treatment by fluid replacement therapy (oral rehydration). On the present visit, there was a new complaint on severe abdominal pain. The patient mentioned that she was in her first day of her menstruation cycle. She passed 20 soaked sanitation pads and felt very fatigued. Her blood pressure was 90/50 mmHg. On this day, the laboratory examination revealed platelet = 60,000/mm 3 and hematocrit = 22%. The patient was managed by normal saline infusion and pack red cell transfusion. Contraceptive pill was also given. The patient was hospitalized and improvement within 5 days (the menstruation stopped within 2 days). This case showed pending shock signs. However, it was not a pure dengue shock. Due to heavy menstruation, the patient presented with hypovolumic shock due to excessive blood loss. Indeed, management of dengue shock is usually by simple fluid replacement therapy using saline. However, in this case, due to blood loss, the pack red cell was also provided. In addition, contraceptive pill was also used for menstruation cessation. The severe menstruation as a presentation of dengue is uncommon and can be problematic. [1],[2] The present case study is not the case with excessive menstruation as presentation of dengue, but it is a very rare and problematic case wherein the patient developed menstruation during the course of severe thrombocytopenia due to dengue.

References

1Wiwanitkit S, Wiwanitkit V. Excessive menstruation bleeding as a presentation of dengue hemorrhagic fever. Arch Gynecol Obstet 2012.
2Wiwanitkit V. Bleeding and other presentations in Thai patients with dengue infection. Clin Appl Thromb Hemost 2004;10:397-8.