Dengue in a Post PCNL Patient – Vigilance and Sucpiscion Matters

Abstract

Dengue is a rapidly spreading mosquito-borne viral disease. The spectrum of clinical manifestations ranges from subclinical infections to severe dengue with leaky membranes, haemorrhagic manifestations, shock and organ dysfunction and finally death. Haematuria with fever in a post PCNL setting is a common finding. Severe haematuria require transfusion in around 11.2-17.5% patients and angioembolization in around 0.8% cases. We present a case of haematuria with fever in a young patient who underwent PCNL for partial staghorn calculus. She developed fever on second post-operative day, diagnosed dengue positive on fifth post-operative day, became anuric and went into dengue shock syndrome on sixth post-operative day. She recovered well after haemodialysis and multiple platelet and packed cell transfusion on eleventh post-operative day. We here want to highlight the importance of a multidisciplinary team approach and high level of vigilance and suspicion for dengue when a post-operative PCNL patient develops fever with haematuria.