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Severe dengue infection is associated with life-threatening complications, including severe bleeding. The bleeding tendency is typically associated with the shock phase of infection, for which blood replacement may be needed. However, repetitive blood transfusion can lead to volume overload. Administration of recombinant activated factor VII (rFVIIa) might be used to counteract bleeding without inducing volume overload. We describe the case of a patient with severe dengue infection who presented with intractable bleeding; he was initially treated with massive blood transfusions, which resulted in volume overload. He was then treated with rFVIIa to reverse the bleeding. During the second week of his hospitalization, his hematocrit dropped precipitously, and autoimmune hemolytic anemia was diagnosed. Supportive treatment was provided until recovery. Autoimmune hemolytic anemia is a rare complication in adult patients with dengue. Supportive care was effective for this atypical complication.

Background A Janus kinase 2 (JAK2) mutation polycythemia vera (PV) is a common manifestation of stem cell disorder. However, available data on the clinical and treatment response of JAK2-negative PV patients are limited. Objectives We report the case and clinical course of a patient with PV and left hemiparesis who was JAK2V617-negative. Methods We conducted a literature review and compared our patient with previously published reports of JAK2-negative patients with P V. Results Our patient presented with hemiparesis without a previous history of hematological disease. He was diagnosed with PV based on the British Committee for Standards in Haematology guidelines 2007. He underwent only phlebotomy with subsequent improvement of his neurological condition. He was discharged with therapeutic phlebotomy for one and a half months. Conclusions Although this rare condition required complex diagnostic criteria, the patient achieved good clinical outcome with therapeutic phlebotomy alone.

Background: Primary granulocytic sarcoma (GS) only rarely presents with an ovarian mass classified as extramedullary myeloid progenitor tumor cells. Few patients with cases of primary GS survive after systemic chemotherapy. Objective: To present a case of primary GS treated with complete course of chemotherapy. The patient is currently in complete remission. Methods: Retrospective review of medical records and comparison with previous case reports. Results: A 41-year-old woman presented with an ovarian mass of 6 months duration. There was no previous history of hematologic disease or presence of leukemic cells in other organs at the time of diagnosis. Immunohistochemistry confirmed the diagnosis. She received complete course of chemotherapy, after which complete remission was achieved. Conclusion: A case of primary granulocytic sarcoma of the ovary was successfully treated with chemotherapy. This disease needs careful diagnosis and appropriate treatment for a good outcome.