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Journal of Case Reports
Spontaneous Muscle Hematoma in Dengue Hemorrhagic Fever: A Report of Four Cases
Bhargavan Pallivalappil, Supreeth Ramesh Naga, Dipu KP, Robin George Manappallil 
Department of Internal Medicine, Baby Memorial Hospital, Calicut, Kerala, India. 
Corresponding Author:
Dr. Supreeth R N
Email: supreeth22@gmail.com
Received: 11-MAR-2018 Accepted: 14-APR-2018 Published Online: 10-MAY-2018
DOI: http://dx.doi.org/10.17659/01.2018.0031
Background: Dengue is the most common arboviral infection in the world. Dengue hemorrhagic fever (DHF) presents with manifestations like bleeding gums, melena, menorrhagia, epistaxis and hemoptysis which are well documented. Spontaneous intra-muscular hematoma is a rare manifestation of DHF and very few such cases were reported so far. Case Report: We report four cases of DHF complicated by spontaneous muscle hematomas, of which three were managed conservatively and one case needed transcatheter embolization. Conclusion: Sudden onset abdominal or back pain with decreasing hemoglobin level in the setting of dengue fever should incite a suspicion of spontaneous muscle hematoma. Nevertheless, orificial bleeding should be ruled out first. Diagnosis is by ultrasonogram or computerised tomography. Such cases are managed conservatively with fluid resuscitation, packed cell transfusion and analgesia. Most of the patients improve well with appropriate management. Intervention by embolization is rarely needed.
Keywords : Abdominal Wall, Dengue, Epistaxis, Hematoma, Hemoptysis.
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