An Elderly Female with Pulmonary Oedema Manifestation of Dengue Hemorrhagic Fever : a Case Report


  • Mikhael Fabian Gunawan Rumah Sakit Simpangan, Departemen Emergency, Depok, Indonesia
  • Mohammad Bhukkar Adil Sjam Rumah Sakit Simpangan, Departemen Penyakit Dalam, Depok, Indonesia
  • Adriana Viola Miranda Global Health Focus, London, United Kingdom



Dengue, Fever, Pulmonary edema


Dengue Hemorrhagic Fever (DHF) is an arthropod borne viral disease. The main vector of the disease are the Aedes mosquitoes. Indonesia as one of the tropical nations in South Asia falls into one of the countries in which DHF is an endemic. The notable clinical symptoms are fever usually 400c with a  biphasic pattern in 6% of DHF cases, body ache, muscles, retroorbital and joints, nausea, and vomiting. Fluid accumulation, due to plasma leakage, may occur in the abdominal cavities, pleural space, and even the lungs. The rise of non-communicable diseases like diabetes mellitus has impacted the clinical progression of DHF by increasing the risk of developing into dengue shock syndrome and atypical clinical manifestation of dengue plasma leakage and bleeding disorder. This case report discusses one of these atypical clinical manifestations of DHF. The case is an elderly female presenting in the emergency room with a DHF, Diabetes mellitus type 2, cardiomegaly, and during inpatient care developed a pulmonary Oedema.  The patient experienced prolonged fever and on the 7th day of care develops a pulmonary oedema, the patient is then moved to the intensive care unit, and with proper treatment and monitoring was able to recover from the disease


[1]. Harapan H, Michie A, Mudatsir M, Sasmono RT, Imrie A. Epidemiology of dengue hemorrhagic fever in Indonesia: analysis of five decades data from the National Disease Surveillance. BMC Res Notes. 2019 Jun 20;12(1):350. doi: 10.1186/s13104-019-4379-9. PMID: 31221186; PMCID: PMC6587249.

[2]. Schaefer TJ, Panda PK, Wolford RW. Dengue Fever. [Updated 2022 Nov 14]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from:

[3]. Martina BE, Koraka P, Osterhaus AD. Dengue virus pathogenesis: an integrated view. Clin Microbiol Rev. 2009 Oct;22(4):564-81. doi: 10.1128/CMR.00035-09. PMID: 19822889; PMCID: PMC2772360.

[4]. Islam MT, Quispe C, Herrera-Bravo J, Sarkar C, Sharma R, Garg N, et al. Production, transmission, pathogenesis, and control of dengue virus: A literature-based undivided perspective [Internet]. Hindawi; 2021 [cited 2023 Jun 19]. Available from:

[5]. de Almeida RR, Paim B, de Oliveira SA, Souza AS Jr, Gomes ACP, Escuissato DL, Zanetti G, Marchiori E. Dengue Hemorrhagic Fever: A State-of-the-Art Review Focused in Pulmonary Involvement. Lung. 2017 Aug;195(4):389-395. doi: 10.1007/s00408-017-0021-6. Epub 2017 Jun 13. PMID: 28612239; PMCID: PMC7102422.

[6]. Rajapakse S, Rodrigo C, Rajapakse A. Treatment of dengue fever. Infect Drug Resist. 2012;5:103-12. doi: 10.2147/IDR.S22613. Epub 2012 Jul 23. PMID: 22870039; PMCID: PMC3411372.

[7]. Singh R, Goyal S, Aggarwal N, Mehta S, Kumari P, Singh V, Chopra H, Emran TB. Study on dengue severity in diabetic and non-diabetic population of tertiary care hospital by assessing inflammatory indicators. Ann Med Surg (Lond). 2022 Sep 16;82:104710. doi: 10.1016/j.amsu.2022.104710. PMID: 36268329; PMCID: PMC9577853.

[8]. Marchiori E, Hochhegger B, Zanetti G. Pulmonary manifestations of dengue. J Bras Pneumol. 2020 Mar 2;46(1):e20190246. doi: 10.1590/1806-3713/e20190246. PMID: 32130344; PMCID: PMC7462676.

[9]. Amin H, Siddiqui WJ. Cardiomegaly. [Updated 2022 Nov 20]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from:

[10]. Araiza-Garaygordobil D, García-Martínez CE, Burgos LM, Saldarriaga C, Liblik K, Mendoza I, Martinez-Selles M, Scatularo CE, Farina JM, Baranchuk A; Neglected Tropical Diseases and other Infectious Diseases affecting the Heart (the NET‐Heart) project. Dengue and the heart. Cardiovasc J Afr. 2021 Sep-Oct 23;32(5):276-283. doi: 10.5830/CVJA-2021-033. Epub 2021 Jul 20. PMID: 34292294; PMCID: PMC8756038.

[11]. David A. Muller and others, Clinical and Laboratory Diagnosis of Dengue Virus Infection, The Journal of Infectious Diseases, Volume 215, Issue suppl_2, 1 March 2017, Pages S89–S95,

[12]. Wiwanitkit V. Lung disease in Dengue [Internet]. ACT Publishing; 2015 [cited 2023 Jun 20]. Available from:

[13]. Reddy KBK, Basavaraja G, Shivananda. Furosemide Infusion in Children with Dengue Fever and Hypoxemia [Internet]. Indian Academy of Pediatrics; 2014 [cited 2023 Jun 20]. Available from:,the%20need%20for%20mechanical%20ventilation.

[14]. Madanayake, P., Jayawardena, A., Wijekoon, S.L. et al. Fluid requirement in adult dengue haemorrhagic fever patients during the critical phase of the illness: an observational study. BMC Infect Dis 21, 286 (2021).




How to Cite

Gunawan, M. F., Sjam, M. B. A., & Miranda, A. V. (2023). An Elderly Female with Pulmonary Oedema Manifestation of Dengue Hemorrhagic Fever : a Case Report . Jurnal Profesi Medika : Jurnal Kedokteran Dan Kesehatan, 17(2), 108–113.