Infection

, Volume 40, Issue 4, pp 441–443 | Cite as

Fatal dengue hemorrhagic fever imported into Germany

  • J. Schmidt-Chanasit
  • K. Tenner-Racz
  • D. Poppert
  • P. Emmerich
  • C. Frank
  • C. Dinges
  • R. Penning
  • A. Nerlich
  • P. Racz
  • S. Günther
Case Report

Abstract

Dengue virus (DENV) is an arthropod-borne virus (family Flaviviridae) causing dengue fever or dengue hemorrhagic fever. Here, we report the first fatal DENV infection imported into Germany. A female traveler was hospitalized with fever and abdominal pain after returning from Ecuador. Due to a suspected acute acalculous cholecystitis, cholecystectomy was performed. After cholecystectomy, severe spontaneous bleeding from the abdominal wound occurred and the patient died. Postmortem analysis of transudate and tissue demonstrated a DENV secondary infection of the patient and a gallbladder wall thickening (GBWT) due to an extensive edema.

Keywords

Dengue virus Germany Dengue hemorrhagic fever Immunohistochemistry 

Notes

Conflict of interest

The authors declare that they have no conflict of interest.

References

  1. 1.
    Allwinn R. Significant increase in travel-associated dengue fever in Germany. Med Microbiol Immunol. 2011;200:155–9.PubMedCrossRefGoogle Scholar
  2. 2.
    Gubler DJ. Epidemic dengue/dengue hemorrhagic fever as a public health, social and economic problem in the 21st century. Trends Microbiol. 2002;10:100–3.PubMedCrossRefGoogle Scholar
  3. 3.
    Whitehorn J, Farrar J. Dengue. Br Med Bull. 2010;95:161–73.PubMedCrossRefGoogle Scholar
  4. 4.
    Schmidt-Chanasit J, Haditsch M, Schoneberg I, Gunther S, Stark K, Frank C. Dengue virus infection in a traveller returning from Croatia to Germany. Euro Surveill. 2010;15. pii: 19677.Google Scholar
  5. 5.
    Dreesman J, Benzler J. Infectious disease surveillance based on the Protection against Infection Act in the German public health sector. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz. 2005;48:979–89.PubMedCrossRefGoogle Scholar
  6. 6.
    Couvelard A, Marianneau P, Bedel C, Drouet MT, Vachon F, Hénin D, Deubel V. Report of a fatal case of dengue infection with hepatitis: demonstration of dengue antigens in hepatocytes and liver apoptosis. Hum Pathol. 1999;30:1106–10.PubMedCrossRefGoogle Scholar
  7. 7.
    Huerre MR, Lan NT, Marianneau P, Hue NB, Khun H, Hung NT, Khen NT, Drouet MT, Huong VT, Ha DQ, Buisson Y, Deubel V. Liver histopathology and biological correlates in five cases of fatal dengue fever in Vietnamese children. Virchows Arch. 2001;438:107–15.PubMedGoogle Scholar
  8. 8.
    Seneviratne SL, Malavige GN, de Silva HJ. Pathogenesis of liver involvement during dengue viral infections. Trans R Soc Trop Med Hyg. 2006;100:608–14.PubMedCrossRefGoogle Scholar
  9. 9.
    Oliveira GA, Machado RC, Horvat JV, Gomes LE, Guerra LR, Vandesteen L, Oliveira FT, Lousada NS, Moreira-Silva S, de Fatima Ceolin M. Transient reticular gallbladder wall thickening in severe dengue fever: a reliable sign of plasma leakage. Pediatr Radiol. 2010;40:720–4.PubMedCrossRefGoogle Scholar
  10. 10.
    Schilling S, Emmerich P, Günther S, Schmidt-Chanasit J. Dengue and Chikungunya virus co-infection in a German traveller. J Clin Virol. 2009;45:163–4.PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag 2011

Authors and Affiliations

  • J. Schmidt-Chanasit
    • 1
  • K. Tenner-Racz
    • 2
  • D. Poppert
    • 3
  • P. Emmerich
    • 1
  • C. Frank
    • 4
  • C. Dinges
    • 5
  • R. Penning
    • 5
  • A. Nerlich
    • 6
  • P. Racz
    • 2
  • S. Günther
    • 1
  1. 1.Department of Virology, Clinical Virology LaboratoryBernhard Nocht Institute for Tropical MedicineHamburgGermany
  2. 2.Department of PathologyBernhard Nocht Institute for Tropical MedicineHamburgGermany
  3. 3.Academy for Psychosomatic Medicine and PsychotherapyMunichGermany
  4. 4.Robert Koch InstituteBerlinGermany
  5. 5.Department of Forensic MedicineUniversity of MunichMunichGermany
  6. 6.Department of PathologyKlinikum BogenhausenMunichGermany

Personalised recommendations