Published: 2016-12-19

Rectus sheath haematoma complicating dengue haemorrhagic fever-a case report

Harharpreet Kaur, Kawalinder Girgila


Dengue hemorrhagic fever manifests in various forms, ranging from petechial skin hemorrhages to life threatening hemorrhages. However it is very rare to have muscle hematomas in this condition. We report a case of spontaneous Rectus sheath hematoma complicating dengue hemorrhagic fever. Our patient was a 55 year old female positive for NS1antigen and anti-dengue IgM. She had thrombocytopenia with platelet counts as low as 12000 in the beginning. There was evidence of plasma leakage and acute dyspnoea during the course of illness. On the 5th day though the platelet count had recovered she developed haematoma in the left rectus sheath which was diagnosed on ultrasound and aspirated leading to relief of symptoms. This complication needs to be recognized so that it can be treated early.


Dengue hemorrhagic fever, Rectus sheath haematoma, Thrombocytopenia

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Gubler DJ. Dengue and dengue haemorrhagic fever. Clin Microbiol Rev. 1998;11:480-96.

Ganeshwaran Y, Seneviratne SM, Jayamaha R, De Silva AP, Balasuriya WK. Dengue fever associated with a hematoma of the rectus abdominis muscle. Ceylon Med J. 2001;46:105-6.

Khalid J, Rabia S, Hamad J. Abdominal haematomas and dengue fever: Two different cases of spontaneous psoas muscle haematoma and bilateral rectus sheath haematoma complicating dengue haemorrhagic fever. J Family Med Prim Care. 2014;3(2):159-60.

Anurag S, Sonia B, Rajendra P Gaurav M. Dengue Fever with Rectus Sheath Hematoma: A Case Report. J Family Med Prim Care. 2014;3(2):159-60.

Ammer AM, Arachichi WK, Jayasingha PA. Psoas hematoma complicating dengue hemorrhagic fever: A case report. Galle Med J. 2009;14:83-4.

Ganu S, Mehta Y. Femoral compressive neuropathy from iliopsoas hematoma complicating Dengue haemorrhagic fever. Asian Pac J Trop Med. 2013;6:419-20.

Potts JA, Rothman AL. Clinical and laboratory features that distinguish dengue from other febrile illnesses in endemic populations. Trop Med Inter Health. 2008;13(11):1328-40.

Costello J, Wright J. Rectus sheath haematoma: ‘A diagnostic dilemma?’ Emerg Med J. 2005;22(7):523-4.