лихорадка Денге, инфекционные заболевания, вирусные геморрагические лихорадки, тропические болезни, Бразилия, Medicine

Dengue fever (DF) is a common cause of arboviral infections in South America, belonging to the genus Flavivirus. Only in Fortaleza, the 5 th most populated city in Brazil, in the year of 2011 over 110 cases of dengue fever by day were being registered [3]. DF is only rarely considered as a cause of acute liver failure [4], while this particular case involves three different systems, being the reason why it called our attention. 50 year old, male, conscious, presents to São José Hospital of Infectious Diseases with classic dengue fever symptoms, being the day of his admission the 9 th since the first symptoms erupted. Other causes for acute hepatic failure like acute viral hepatitis, leptospirosis, malaria, Reyes syndrome were ruled out, had the patient already been tested for dengue IgM in a local hospital. Complained of a pain in his abdomen, simple thorax radiography showed an enlarged cardiac area. His ECG reinforced the cardiac enzymes’ results, showing a clear alteration in ventricular repolarization. Patient progressed with shock, cardiac insufficiency and ischemic hepatitis. With treatment for the multiple conditions he made a significant clinical and biochemical improvement. He was discharged after 33 days of hospital stay.