Case study: Disseminated Intravascular Coagulation due to Dengue Hemorrhagic Fever in a Thalassemia Patient with Human Immunodeficiency and Hepatitis B Virus

Abstract

A case study report of a 35-year-old Cambodian male from Bangkok who was admitted to the Hospital for Tropical Diseases in Thailand with high grade fever. The patient was diagnosed with dengue hemorrhagic fever at the day of admission. The laboratory examinations showed positive for Human immunodeficiency virus (HIV) and Hepatitis B virus (HBV) coinfection in Thalassemia carrier. He had complications with disseminated intravascular coagulation, severe bleeding, hepatorenal syndrome (HRS), hepatic encephalopathy, hyperkalemia, hypocalcemia and metabolic acidosis. A low CD4+ count may contribute to severe bacterial sepsis leading to septic shock. Methicillin-resistant Staphylococcus aureus (MRSA) was identified and isolated from the patient bloodstream. The bacteria were susceptible to vancomycin at the minimum inhibitory concentration (MIC) of 1.5 µg/mL. Urinary catheter specimen culture found Staphylococcus aureus (MRSA) > 10⁵CFU/mL, which was susceptible to the vancomycin with the lowest MIC of 1.5 µg/mL. All of these can lead to severe disease and result in multiple organ dysfunction. The patient died 3 days later because of complications.