Lassa fever presenting as acute abdomen: a case series

Area of Science:

• Infectious Diseases
• Viral Hemorrhagic Fevers
• Surgical Emergencies

Background:

• Lassa fever is an endemic zoonotic disease in West Africa.
• It presents with diverse symptoms, often mimicking other conditions.
• Acute abdomen presentations frequently lead to surgical intervention.

Observation:

• Seven patients with suspected surgical emergencies (appendicitis, typhoid ileitis, intussusception, ectopic pregnancy) were diagnosed with Lassa fever post-operatively.
• Routine investigations did not initially suggest Lassa fever.
• Four patients died before ribavirin treatment could commence.

Findings:

• Lassa fever was confirmed in all seven surgically treated patients.
• Delayed ribavirin therapy due to misdiagnosis increased morbidity and mortality.
• Three patients recovered with ribavirin and antibiotic treatment.

Implications:

• Surgeons in endemic areas must consider Lassa fever in the differential diagnosis of acute abdomen.
• Fever, proteinuria, and thrombocytopenia in acute abdomen cases warrant Lassa fever suspicion.
• Prolonged intraoperative bleeding may indicate Lassa fever and necessitate infection control measures.