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Case Reports in Anesthesiology
Volume 2011 (2011), Article ID 896783, 3 pages
http://dx.doi.org/10.1155/2011/896783
Case Report

Filgrastim as a Rescue Therapy for Persistent Neutropenia in a Case of Dengue Hemorrhagic Fever with Acute Respiratory Distress Syndrome and Myocarditis

Department of Anaesthesiology and Intensive Care, Postgraduate Institute of Medical Education and Research and Dr Ram Manohar Lohia Hospital, New Delhi 10041, India

Received 14 August 2011; Accepted 22 September 2011

Academic Editors: S. Grigoriadis and H. Shankar

Copyright © 2011 Desh Deepak et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Pathogenesis of dengue involves suppression of immune system leading to development of characteristic presentation of haematological picture of thrombocytopenia and leucopenia. Sometimes, this suppression in immune response is responsible for deterioration in clinical status of the patient in spite of all specific and supportive therapy. Certain drugs like steroids are used for rescue therapy in conditions like sepsis. We present a novel use of filgrastim as a rescue therapy in a patient with dengue hemorrhagic fever (DHF) with acute respiratory distress syndrome (ARDS), myocarditis, and febrile neutropenia and not responding to standard management.