Dengue Infection: Not Just Fever—A Rare Presentation with Literature Review

Abstract

Dengue fever is a common viral infection in the tropical areas, especially in India. However, dengue infection presenting as hemorrhagic encephalitis is rare. A 10-year-old girl presented with fever, headache, vomiting, and seizures followed by altered sensorium. Her blood serum was positive for antidengue immunoglobulin M enzyme-linked immunosorbent assay (ELISA) and NS1Ag, and cerebrospinal fluid study showed lymphocytic pleocytosis. Magnetic resonance imaging T2-weighted and fluid-attenuated inversion recovery (FLAIR) images showed hyperintensities involving the bilateral thalami, pons, and midbrain with patchy hemorrhage. Despite all supportive measures, she expired 3 days after admission. Our case highlights that dengue encephalitis may present even in the absence of other classical signs.

Keywords

dengue fever - brainstem involvement - hemorrhagic encephalitis

Key Messages

1. Dengue encephalitis is a rare manifestation of dengue fever.

2. Dengue encephalitis may present even in the absence of classical clinical features of dengue fever.

Authors' Contributions

N.B. contributed in data collection, literature review, and preparation of the manuscript. P.C.G. conceptualized and supervised the data, critically reviewed the article, and will act as guarantor for the article. R.S. supervised the data and critically reviewed the article. A.M.K. took part in data acquisition and critically reviewed the article

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