ABSTRACT

Background : ToF is belong to cyanotic heart disease group, which is have polycythemia and a high baseline haematocrit. A heart defect that features four problems, they are: a hole between the lower chambers of the heart ,  an obstruction from the heart to the lungs, the aorta lies over the hole in the lower chambers, the muscle surrounding the lower right chamber becomes overly thickened. Dengue viral infection in patients with ToF, would have a greater potential for the occurrence of heart failure, the baseline of haematocrit is already higher compare with non congenital heart disease. Case : A 22 year-old man complains of coming with fever since 3 days before hospitalized, high fever directly, nausea, no vomiting, chill, abdominal pain and headache. Normal urinate, no pain during his urination and normal bowel. No obtained of complaint of nosebleed, gum bleeding, petechiaeae. Beside this, the patient complaint of intermittent breathless since he was 2-month-old, accompanied by swelling and blue colors of the fingers. Leucocyte 4100/μL, platelet 50,000/μL, hematocrit 70%. Discussions : In the management of this patient, we should be more careful because there was comorbid of ToF. The focus of the management is to prevent dehydration on the critical phase and aware of overhydration  in the recovery phase. The principle treatment is enough rest, rehydration to achive normal range of haematocrite (around 65%), and avoid drugs that may precipitate bleeding(like salycilic acid). Conclusion : It has been reported of a man aged 22 years with dengue viral infection and tetralogy of fallot. In the management of this patient, we should be more careful because there was comorbid of ToF. The focus of the management is to prevent dehydration on the critical phase and aware of overhydration in the recovery phase.

Key words : Dengue, Tetralogy of Fallot