{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,2]],"date-time":"2026-03-02T14:21:56Z","timestamp":1772461316485,"version":"3.50.1"},"reference-count":11,"publisher":"American Society of Tropical Medicine and Hygiene","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2019,8,7]]},"abstract":"<jats:p>Dengue hemorrhagic fever is one of the most commonly encountered mosquito-borne viral infections of humans worldwide with multiple reported outbreaks. Cardiac involvement is a known manifestation of the disease usually presenting as rhythm abnormalities, myocarditis, or pericardial effusion, which may be clinically asymptomatic. We describe a case of a 30-year-old woman who presented to us with high-grade fever, headache, retro-orbital pain, generalized maculopapular rash with bilateral pleural effusion, and hypotension. Dengue non-structural protein 1 (NS1) antigen and IgM antibodies were positive on admission, supporting a diagnosis of dengue hemorrhagic fever. Cardiac troponin-I was elevated on admission (65 ng\/L) with diffuse convex ST segment elevations on electrocardiogram, suggestive of possible myopericarditis. Echocardiogram on admission revealed minimal pericardial effusion with preserved ejection fraction. Despite administration of fluids and inotrope use, the patient\u2019s hypotension progressively deteriorated over the next 6 hours, associated with decreased urine output and worsening sensorium. Clinical examination revealed muffled heart sounds and raised jugular venous pressure. A repeat echocardiogram confirmed an increase in the pericardial effusion manifesting as cardiac tamponade. Ultrasound-guided pigtail catheter insertion led to a prompt removal of the excessive pericardial fluid and correction of hypotension. Early identification of this uncommon but important complication of dengue hemorrhagic fever led to a good outcome in our case.<\/jats:p>","DOI":"10.4269\/ajtmh.19-0153","type":"journal-article","created":{"date-parts":[[2019,6,4]],"date-time":"2019-06-04T07:31:54Z","timestamp":1559633514000},"page":"448-450","source":"Crossref","is-referenced-by-count":13,"title":["Case Report: Cardiac Tamponade in Dengue Hemorrhagic Fever: An Unusual Manifestation of a Common Disease"],"prefix":"10.4269","volume":"101","author":[{"given":"Sagnik","family":"Biswas","sequence":"first","affiliation":[{"name":"Department of Medicine, All India Institute of Medical Sciences, New Delhi, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Prabhat","family":"Kumar","sequence":"additional","affiliation":[{"name":"Department of Medicine, All India Institute of Medical Sciences, New Delhi, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ghazal","family":"Tansir","sequence":"additional","affiliation":[{"name":"Department of Medicine, All India Institute of Medical Sciences, New Delhi, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ashutosh","family":"Biswas","sequence":"additional","affiliation":[{"name":"Department of Medicine, All India Institute of Medical Sciences, New Delhi, India"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"2795","reference":[{"key":"b1","series-title":"Trans R Soc Trop Med Hyg","first-page":"804","article-title":"Cardiac complications of a dengue fever outbreak in Sri Lanka, 2005","volume":"101","author":"Kularatne","year":"2007"},{"key":"b2","series-title":"Circulation","first-page":"e519","article-title":"Dengue myopericarditis mimicking acute myocardial infarction","volume":"131","author":"Ramanathan","year":"2015"},{"key":"b3","series-title":"Pediatr Infect Dis J","first-page":"238","article-title":"Heart and skeletal muscle are targets of dengue virus infection","volume":"29","author":"Salgado","year":"2010"},{"key":"b4","series-title":"Pediatr Radiol","first-page":"1","article-title":"Dengue haemorrhagic fever: ultrasound as an aid to predict the severity of the disease","volume":"28","author":"Setiawan","year":"1998"},{"key":"b5","series-title":"J Intensive Care Med","first-page":"175","article-title":"Cardiac tamponade in a patient with dengue fever and lupus nephritis: a case report","volume":"25","author":"Kumar","year":"2010"},{"key":"b6","series-title":"J Assoc Physicians India","first-page":"257","article-title":"Cardiac tamponade presenting as early manifestation in dengue fever","volume":"62","author":"Bendwal","year":"2014"},{"key":"b7","series-title":"Rev Soc Bras Med Trop","first-page":"701","article-title":"Cardiac tamponade in a patient with severe dengue fever","volume":"50","author":"Fernandes","year":"2017"},{"key":"b8","series-title":"Thromb Haemost","first-page":"1042","article-title":"Plasma leakage in dengue haemorrhagic fever","volume":"102","author":"Srikiatkhachorn","year":"2009"},{"key":"b9","series-title":"PLoS Negl Trop Dis","first-page":"e0003943","article-title":"Evaluation of cardiac involvement in children with dengue by serial echocardiographic studies","volume":"9","author":"Kirawittaya","year":"2015"},{"key":"b10","series-title":"Int J Infect Dis","first-page":"e919","article-title":"Acute myocarditis in dengue hemorrhagic fever: a case report and review of cardiac complications in dengue-affected patients","volume":"14","author":"Lee","year":"2010"},{"key":"b11","series-title":"J Assoc Physicians India","first-page":"40","article-title":"Cardiac manifestation in dengue fever","volume":"64","author":"Arora","year":"2016"}],"container-title":["The American Journal of Tropical Medicine and Hygiene"],"original-title":[],"link":[{"URL":"https:\/\/www.ajtmh.org\/view\/journals\/tpmd\/101\/2\/article-p448.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.ajtmh.org\/downloadpdf\/journals\/tpmd\/101\/2\/article-p448.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/www.ajtmh.org\/downloadpdf\/journals\/tpmd\/101\/2\/article-p448.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,7,31]],"date-time":"2024-07-31T14:56:03Z","timestamp":1722437763000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ajtmh.org\/view\/journals\/tpmd\/101\/2\/article-p448.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,8,7]]},"references-count":11,"journal-issue":{"issue":"2"},"URL":"https:\/\/doi.org\/10.4269\/ajtmh.19-0153","relation":{},"ISSN":["0002-9637","1476-1645"],"issn-type":[{"value":"0002-9637","type":"print"},{"value":"1476-1645","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,8,7]]}}}