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Repeated dengue shock syndrome and "Dengue myocarditis" responding dramatically to a single dose methyl prednisolone

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dc.contributor.author Premaratna, R.
dc.contributor.author Rodrigo, K.M.D.
dc.contributor.author Anuratha, A.
dc.contributor.author de Alwis, V.K.D.
dc.contributor.author Perera, U.D.C.A.
dc.contributor.author de Silva, H.J.
dc.date.accessioned 2016-03-30T07:46:39Z
dc.date.available 2016-03-30T07:46:39Z
dc.date.issued 2012
dc.identifier.citation Sri Lanka Medical Association, 125th International Medical Congress. 2012;57 Suppliment1: 106 en_US
dc.identifier.issn 0009-0895
dc.identifier.uri http://repository.kln.ac.lk/handle/123456789/12392
dc.description Poster Presentation Abstract (PP 76), 125th Anniversary Scientific Medical Congress, Sri Lanka Medical Association, June 2012 Colombo, Sri Lanka en_US
dc.description.abstract INTRODUCTION: Place of steroids in the management of severe dengue is unclear. A retrospective observational study appeared to show benefit of methylprednisolone (MP) in a highly selected group of patients. CASE REPORT: A 14-year-old schoolboy developed "myocarditis" (4th day) and on the fifth day, he collapsed with Dengue shock syndrome DSS needing rapid resuscitation with intravenous fluid boluses and dextran. He continued to have high fever (39-410C), and pulse rate (PR)>110/min and developed two further episodes of DSS and was resuscitated with further boluses of dextran. As there was no response with temperature 40.20C, PR 160/min, mid-arm systolic BP 70 mmHg, confused, restless, respiratory rate 36/min, dropping capillary 02 saturation, moderate pleural effusions and ascites, urine output <0.2ml/kg/Hr, made it extremely difficult to select the amount and type of fluid for resuscitation. Due to rapid deterioration a single dose of methylprednisolone (MP) (SOOmg in 200ml saline iv over 20 minutes) was administered as a rescue medication. He had deferversence within 30 minutes, became conscious and alert in 1 hour, PR reduced to 96/minute, BP remained stable above 100/80mmHg and urine output increased to 0.8-1.4ml/Kg/Hr. His ECG became normal after 3 hours, and the echo cardiogram in 12 hours (EF-55%). CONCLUSIONS: This patient with dengue developed three episodes of severe haemodynamic compromise within 12 hours while having third space fluid accumulation, "myocardits" and altered level of consciousness making it difficult to institute fluid therapy. A single dose of MP given as rescue measure resulted in a dramatic recovery suggesting a beneficial effect of MP in sever dengue.by en_US
dc.language.iso en_US en_US
dc.publisher Sri Lanka Medical Association en_US
dc.subject Dengue en_US
dc.subject.mesh Severe Dengue en_US
dc.title Repeated dengue shock syndrome and "Dengue myocarditis" responding dramatically to a single dose methyl prednisolone en_US
dc.type Conference Abstract en_US


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