Spontaneous Venous Thrombosis in Patients with Dengue Fever: A Systematic Analysis of Published Case Reports.

Introduction: Spontaneous venous thrombosis (SVT) in patients with dengue fever (DF) is a rare and complex phenomenon. The coexistence of thrombosis and hemorrhagic tendencies due to thrombocytopenia and dengue hemorrhagic fever complicates management decisions. This systematic review aims to analyze the etiology, clinical presentation, management strategies, and outcomes reported in the English literature for such cases. Methods: A comprehensive search of PubMed, CINAHL, Cochrane Library, Clinical Key, and Google Scholar databases was conducted up to October 31, 2024. Studies reporting SVT in DF were included, and data on demographics, diagnostic methods, treatment modalities, complications, and outcomes were extracted. This review adheres to Cochrane collaboration guidelines and follows the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 statement. Results: Fifteen studies comprising 19 patients met the inclusion criteria. The mean age was 43.26 years, with a median onset of SVT occurring 6 days after fever onset. Majority (57.8%, 11/19) presented with thrombocytopenia (<52,000/mm³), and 57.8% (11/19) received subcutaneous low-molecular-weight heparin. Despite complexities, all patients survived without major bleeding complications. Conclusion: SVT in DF highlights the potential coexistence of thrombotic and hemorrhagic states. A standardized approach with anticoagulation appears effective in managing these challenging cases.