The sequelae of epidemic hemorrhagic fever. With a note on causes of death

Robert B. Giles, John A. Sheedy, Carl N. Ekman, Herman F. Froeb, Charles C. Conley, Joe L. Stockard, David W. Cugell, John W. Vester, Robert K. Kiyasu, George Entwisle, Robert H. Yoe

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22 Scopus citations


The complications observed in 828 cases of hemorrhagic fever, with their incidence, time of appearance, duration and sequelae, are described. Some of the clinical observations that may be related to the causes of these phenomena are discussed. 1. 1. Sixteen per cent of the patients had clinical shock. One-third of these eventually died. Hypotension not associated with shock carried a good prognosis. 2. 2. Hemorrhagic complications were encountered throughout the course of the disease but were rarely the primary cause of death. 3. 3. Significant hypertension was encountered in 25 per cent of the patients during the oliguric and diuretic phases but was always transient. 4. 4. Electrolyte disturbances were encountered during the oliguric and diuretic phases, hyponatremia and hyperkalemia being the most common. 5. 5. Pulmonary edema was encountered during the oliguric and diuretic phases. Thirteen of fifteen patients with this complication expired. Evidence is presented that heart failure and excessive fluid intake did not contribute significantly to the pulmonary edema observed in this group of cases. 6. 6. Central nervous system complications were observed most frequently during the oliguric and diuretic phases. Although central nervous system involvement contributed to the mortality, no neurologic residua were noted among the survivors. 7. 7. Anemia was encountered in the convalescent phase in several patients and appeared to be related to the severity of the "uremic" phase rather than to blood loss. 8. 8. Only sixteen of 783 surviving patients exhibited residua. Hyposthenuria and anemia were the most frequent.

Original languageEnglish (US)
Pages (from-to)629-638
Number of pages10
JournalThe American journal of medicine
Issue number5
StatePublished - May 1954
Externally publishedYes

ASJC Scopus subject areas

  • Medicine(all)


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