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Severe yellow fever with 23-day survival
M Boulos1, A A Segurado, M Shiroma
1Infectious and Parasitic Diseases Department, University of São Paulo, School of Medicine, Brazil.
Tropical and Geographical Medicine
|October 1, 1988
Summary
This severe jungle yellow fever case in Brazil showed liver and kidney failure. Despite intensive care, the patient succumbed to secondary bacterial pneumonia, though liver regeneration was observed.
Area of Science:
- Tropical Medicine
- Virology
- Critical Care Medicine
Background:
- Jungle yellow fever is a severe arboviral disease with significant mortality.
- Acquisition in the Brazilian mid-west region highlights regional disease epidemiology.
- This case presents a severe manifestation requiring intensive care.
Observation:
- The patient exhibited hepatic and renal failure, cardiovascular disturbance, coma, and bleeding disorder.
- Treatment included intensive care unit (ICU) admission and hemodialysis.
- Despite initial biochemical improvement, the patient developed respiratory failure.
Findings:
- The patient ultimately died from secondary bacterial pneumonia on day 23.
- Post-mortem liver biopsy revealed regeneration of normal liver architecture.
- Survival was likely contingent on avoiding secondary bacterial respiratory complications.
Implications:
- This case underscores the critical risk of secondary infections in severe yellow fever.
- Early recognition and intensive management are crucial for yellow fever patients.
- Liver regeneration capacity in severe yellow fever warrants further investigation.