Conservative Treatment of Spontaneous Intraperitoneal Hemorrhage in Severe Dengue: A Case Report and Review

Abstract

Dengue fever is a common arboviral illness that can result in severe hemorrhagic complications, although spontaneous intraperitoneal bleeding remains rare. We report the case of a 26-year-old previously healthy female who presented with a 4-day history of high-grade fever and myalgia that was later diagnosed as dengue fever. During hospitalization, she developed vaginal bleeding followed by generalized abdominal pain and shock. Contrast-enhanced computed tomography revealed significant hemoperitoneum, despite a normal coagulation profile and no identifiable bleeding source. She was managed conservatively with supportive care and made a full recovery. A 1-year follow-up was unremarkable. This case underscores the importance of early recognition, prompt imaging, and consideration of differential diagnoses. In the absence of established guidelines for managing spontaneous intraperitoneal hemorrhage in dengue, individualized conservative treatment may be effective. Clinicians should remain vigilant for atypical presentations to ensure timely diagnosis and appropriate management.