Transient reticular gallbladder wall thickening in severe dengue fever: a reliable sign of plasma leakage.

BACKGROUND

Dengue fever (DF) is an acute infection caused by a flavivirus. Although most patients present mild symptoms, some progress to a severe condition characterized by hypovolemic shock and hemorrhagic phenomena. The main feature of this severe form of DF is plasma leakage. Gallbladder wall thickening (GBWT), ascites and pleural effusion represent the sonographic triad of plasma leakage in DF.

OBJECTIVE

To evaluate the plasma leakage triad in severe DF with emphasis on the GBWT.

MATERIALS AND

METHODS

Thirty-seven children with severe DF underwent abdominal US on the day of admittance and on the day of discharge, or 7 days after the first examination if the child was still hospitalized.

RESULTS

Of the 37 children, 33 (89.2%) presented GBWT, 29 (78.4%) ascites and 26 (70.3%) pleural effusion. All of these findings had resolved by the second examination. Of the 33 GBWTs, 29 (87.9%) presented a reticular pattern, which could be considered typical of plasma leakage in patients with severe DF.

CONCLUSION

GBWT, ascites and pleural effusion are transient findings in DF. The authors have described a typical reticular pattern of GBWT that can be used to diagnose and follow up on patients with severe DF and should not be considered an acalculous cholecystitis.