The Use of Recombinant Activated Factor VII for Controlling Life-threatening Bleeding in Severe Dengue Fever.

We report a case of severe dengue fever (DF) in a patient who presented with severe bleeding and discuss the role of recombinant activated factor VII (rFVIIa) in managing life-threatening bleeding in these patients. He presented with spontaneous retroperitoneal, gastrointestinal, and bilateral pleural hemorrhage. In all, 39 units of blood and blood products were transfused within 48 hours of admission, but he continued to experience a drop in hemoglobin. At this stage, the role of rFVIIa was discussed with the family, and he was administered 6 mg of rFVIIa intravenously. Following a single dose of rFVIIa, his ongoing bleeding stopped, and his hemoglobin stabilized. No thromboembolic complications were observed. rFVIIa appears to be a promising intervention in maintaining hemostasis in a subset of severe DF patients who continue to bleed despite all possible efforts. Further studies are warranted.