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Rev Med Virol. 2019 Mar;29(2):e2029. doi: 10.1002/rmv.2029. Epub 2019 Jan 4.

Systematic review of spontaneous splenic rupture in dengue-infected patients.

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Faculty of Medicine, Ain Shams University, Cairo, Egypt.
Online Research Club, Nagasaki, Japan,
Faculty of Medicine, Al-Azhar University, Cairo, Egypt.
Faculty of Medicine, Minia University, Minia, Egypt.
Faculty of Medicine, Vo Truong Toan University, Hau Giang, Vietnam.
Oxford University Clinical Research Unit, Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam.
Department of Immunogenetics, Institute of Tropical Medicine (NEKKEN), Nagasaki University, Nagasaki, Japan.
Evidence Based Medicine Research Group, Ton Duc Thang University, Ho Chi Minh City, Vietnam.
Faculty of Applied Sciences, Ton Duc Thang University, Ho Chi Minh City, Vietnam.
Department of Clinical Product Development, Institute of Tropical Medicine (NEKKEN), School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan.


Dengue infection varies from a mild febrile form to more severe disease with plasma leakage, shock, and multiorgan failure. Several serious complications such as cardiomyopathy, encephalopathy, encephalitis, hepatic damage, and neural manifestations cause organ damage in dengue infection. Splenic rupture, a less well known but life-threatening complication, can occur in dengue. The mechanism of splenic rupture in dengue is still unclear. Optimal therapeutic management is required to save the lives of patients with this complication. The objective of this study was to conduct a systematic review of studies documenting the development of spontaneous nontraumatic splenic rupture in patients with dengue infection. In March 2018, a search was conducted systematically in nine electronic databases, in addition to hand- searching. A total of 127 references were exported to Endnote; 47 references remained after removing duplicates. Finally, 16 reports met the inclusion criteria and represented 17 cases. All articles were evaluated and data extracted according to predefined criteria: number of cases, age, sex, severity of dengue disease, days of illness before admission, methods of definitive diagnosis, timing of the event, and management and outcome. A total of 17 individual patients including 13 males and four females were found. Most of the patients were young adults (ranging from 20 to 52 years) and diagnosed with computed tomography scan and managed with splenectomy. Four cases were fatal. Pathological splenic rupture in dengue is a rare, life-threatening condition where timely management can achieve a favorable outcome.


dengue; splenic rupture; spontaneous


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