Colonic Perforation in Dengue Fever: A Case Series

Abstract

Dengue fever is a widespread viral infection endemic in tropical and subtropical regions. While its common manifestations include fever, headache, and musculoskeletal pain, gastrointestinal complications such as colonic perforation are exceedingly rare. Dengue is a viral disease with reported incidence of upto 96 million cases worldwide. Dengue is caused by flavivirus which has 4 serotypes which are antigenicaly distinct (DEN1,2,3,4) and are transmitted by Aedes aegypti mosquito. Symptoms include high fever, headache, rash and muscle and joint pain. It may also cause nausea and vomiting. In severe cases there is serious bleeding and shock, which can be life threatening. This disease is rarely associated with bowel perforation (Ooi et al., 2008). Till now only 10 cases of dengue associated bowel perforation reported worldwide. The site of intestinal perforation was gastric, jejunal or appendicular perforation in these cases (Mandhane et al., 2015; Jain & Viswanath, 2014; Desai et al., 2014; Khanna et al., 2004; Kyle & Harris, 2008). We report three cases of colonic perforation in patients with dengue fever, highlighting the need for prompt recognition and surgical intervention in such atypical presentations.