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Case Reports: Learning from unexpected outcome (positive or negative)
Postoperative dengue haemorrhagic shock and Trichosporon fungal sepsis: a multidisciplinary rescue
  1. Ankit Sachan1,
  2. Rishi Nayyar1,
  3. Arvind Kumar2 and
  4. Vimi Rewari3
  1. 1Urology, All India Institute of Medical Sciences, New Delhi, Delhi, India
  2. 2Medicine, All India Institute of Medical Sciences, New Delhi, Delhi, India
  3. 3Anaesthesiology, Pain Medicine and Critical Care, All India Institute of Medical Sciences, New Delhi, India
  1. Correspondence to Dr Ankit Sachan; ankicool007{at}gmail.com; Dr Rishi Nayyar; nayyarrishi{at}gmail.com

Abstract

A woman in her 30s had robotic pyeloplasty done for right ureteropelvic junction obstruction. Incidentally she developed dengue viral fever starting on postoperative day 1 itself, which progressed to dengue haemorrhagic shock by 1 week, complicating pyeloplasty due to pelvicalyceal haematoma. Dengue associated shock was superimposed with subsequent gram-negative bacterial sepsis, further complicated later with Trichosporon fungal sepsis. She was managed under multidisciplinary care, involving urology, infectious disease and ICU care. Her diagnostic and difficult management issues due to these rare sequential medical issues in an otherwise usually uncomplicated postsurgical phase are discussed along with short review of literature. This case highlights the importance of early diagnosis, timely supportive care and appropriate management in such tropical infections with significant associated mortality.

  • Infections
  • Urinary tract infections
  • Urinary tract infections

https://doi.org/10.1136/bcr-2022-249814

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    Footnotes

    • AS and RN are joint first authors.

    • Twitter @linktoarvind, @docvimi

    • AS and RN contributed equally.

    • Contributors RN is the guarantor and consultant urologist under whom case was admitted. He performed the surgery and had the authority of final decision making in every aspect of the case. He also helped writing this paper and reviewed it before submission. AS is urology resident managing the case and involved with the patient from admission till discharge and also wrote the template of the article and took informed consent on the publication of this case report. AK is consultant internal medicine and helped with managing the dengue and infectious medicine part of case. VR is consultant anaesthesia and critical care medicine and managed the patient during her stay in intensive care unit and also provided insight about management of patient till discharge of patient.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.