A death due to Dengue Fever with a potential for allegation of medical mis-management

Abstract

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Introduction Despite the improvement in investigation techniques and updated management protocols, dengue continues to bea killer in Sri Lanka. The reason for this is due to late presentations to hospital, prescribing N S A ID by GPs, misdiagnosis, poor monitoring and mismanagement in ward setup. Case R eport A previously-h^althy 10 year old boy presented with a history o f high fever and upper respiratory tract infection for last 3 days.He passed away 48 hours after been admitted to hospital.No external orinternal features of bleeding manifestations were evident. Massive cerebral oedema with 1.7kg of brain weight, 600 ml o f Straw coloured fluids in plural cavity, 800ml of the same type o f fluid in peritoneal cavity and flame shaped haemorrhages in endocardium were evident. Ancillary reports were negative for H iN i, Leptospirosis and Dengue. Histology of all organs was unremarkable. C SF -P C R was positive for Dengue. i Conclusion Cause o f death was given as Dengue Shock Syndrome. Dengue antigen test which is available in M R I can be done on day one in order toassist efficacious management.