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Pain Management 2018
Internal Medicine 2018
International Journal of Anesthesiology & Pain Medicine
ISSN: 2471-982X
Page 53
March 26-28, 2018
Vienna, Austria
JOINT EVENT
7
t h
E d i t i o n o f I n t e r n a t i o n a l C o n f e r e n c e o n
Internal Medicine and Patient Care
&
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t h
E d i t i o n o f I n t e r n a t i o n a l C o n f e r e n c e o n
Pain Management
Volume 4
A
case of a 68-year-oldmanwith past medical history of dengue
hemorrhagic fever who was admitted to themedical intensive
care unit (MICU) with the diagnosis of septic shock. His symptoms
started the prior week with sudden onset of fever, polyarthralgia
and skin rash over the abdomen extending to the back, buttocks
and extremities. The patient visited a community primary care
physician who recommended acetaminophen for symptom relief.
After 2 days of no improvement and development of abdominal
pain, nausea, non-bloody vomiting and dark-colored stools, the
patient visited the emergency department. Physical examination
was remarkable for hypotension, tachycardia, tachypnea and
oxygen desaturation, and a non-blanching maculopapular
rash over the abdomen, back, buttocks, and extremities. No
evidence of acute neurological deficits or cardiopulmonary
involvement. Laboratory workup showed hemoconcentration,
thrombocytopenia, hepatic transaminitis, and acute renal injury,
findings suggestive of circulatory compromise due to systemic
capillary leak syndrome. Patient developed cardiorespiratory
arrest requiring advanced cardiac support measures and
mechanical ventilation for which he was admitted to MICU.
While on MICU, he was initiated on broad spectrum antibiotics,
aggressive fluid resuscitation, and vasopressors. He persisted
with profound shock and died 7 hours after admission to MICU.
Final laboratory reports were remarkable for RNA-PCR positive
for chikungunya virus and negative for dengue virus. Chikungunya
infection is usually a self-limited disease and only required
supportive therapy. This case highlights an unusual presentation
of chikungunya fever with systemic capillary leak syndrome, a
well-known complication of dengue hemorrhagic fever.
Biography
Janet M Colón Castellano completed her Bachelor’s degree in Natural Sci-
ences with a minor on Biotechnology from the University of Puerto Rico
in Ponce. Following her growing research interests in human immunode-
ficiency virus (HIV), she worked as a Laboratory Technician at one of the
few HIV research centers of Puerto Rico. Afterwards, she decided to pursue
a Doctorate in Medicine from the Ponce Health Sciences University which
she completed on 2016. She is currently completing her Internal Medicine
residency at the Veteran’s Affairs Caribbean Healthcare System located in
San Juan, Puerto Rico.
jmcolon@stu.psm.eduFever, hemoconcentration and shock: dengue or chikungunya
infection?
Janet M Colón Castellano, Walter Morales Borrero
and
Jose Gutierrez
VA Caribbean Healthcare system, Puerto Rico
Janet M Colón Castellano et al., Int J Anesth Pain Med 2018, Volume 4
DOI: 10.21767/2471-982X-C1-003