Spontaneous Hemothorax as Isolated Bleeding Manifestation in Dengue Fever

Abstract

Dengue fever is a mosquito-borne illness commonly seen in tropical areas. Thrombocytopenia and bleeding manifestations are the most common complications of dengue fever. Spontaneous hemothorax occurring as an isolated bleeding manifestation is rare in this tropical illness, and there are few case reports of this. We present a case of a middle-aged male patient diagnosed with dengue acute respiratory distress syndrome (ARDS) who went on to develop a massive unilateral spontaneous hemothorax at a nadir platelet count of 29,000 without other bleeding manifestations. Diagnostic thoracocentesis revealed bloody pleural fluid, and the patient was subsequently managed with intercostal tube drainage. This case report highlights the need to bear suspicion of bleeding into the pleural cavity in patients with dengue fever with low platelets, especially those with rapidly increasing pleural effusion, even in the absence of other bleeding manifestations.