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Dengue breathing down our neck: A case report of dengue encephalitis
Lionel HW Lum1, Nares Smitasin2
1MBBS, MRCP UK, Registrar, Infectious Diseases, National University Health System, Singapore.
2MD, Consultant, Infectious Diseases, National University Health System, Singapore.

doi:10.5348/ijcri-2014107-CR-10418

Address correspondence to:
Lionel HW Lum
Division of Infectious Diseases, Department of Medicine
National University Hospital, University Medicine Cluster
Level 10, NUHS Tower block, 1E Kent Ridge Road
Singapore 119228
Phone: +65-97764774
Fax: +65-68724130
Email: lionel.lum@gmail.com

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How to cite this article
Lum LHW, Smitasin N. Dengue breathing down our neck: A case report of dengue encephalitis. Int J Case Rep Images 2014;5(8):600–603.


Abstract
Introduction: There has been a resurgence of dengue worldwide in the tropics and it has emerged as one of the most common mosquito-borne infections brought back by travelers to the temperate regions. Although considered an unusual presentation, dengue encephalitis has to be considered in a returning traveler presenting with fever accompanied by neurological symptoms.
Case Report: A 50-year-old Singaporean female with poorly controlled diabetes presented with a neck abscess. She had persistent fever despite adequate drainage of the abscess. Her repeat blood count four days after the admission revealed that she had developed thrombocytopenia (platelets 13x109/L). She was found to have dengue fever based on a positive serum dengue NS1 antigen. Subsequently, she presented with neurological symptoms. Dengue encephalitis was confirmed by a positive dengue PCR (DEN-4 serotype) on lumbar puncture.
Conclusion: With the increasing incidence of dengue and the expansion of air travel worldwide, one would expect to see an uncommon manifestation such as dengue encephalitis even in non-endemic areas. Dengue encephalitis should be considered in returning travelers from the tropics as well as patients in the endemic areas who present with viral fever and neurological symptoms.

Keywords: Dengue, Encephalitis, Neurological, Fever, Thrombocytopenia


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Author Contributions
Lionel HW Lum – Substantial contributions to conception and design, Acquisition of data, Analysis and interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Nares Smitasin – Acquisition of data, Analysis and interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Guarantor of submission
The corresponding author is the guarantor of submission.
Source of support
None
Conflict of interest
Authors declare no conflict of interest.
Copyright
© 2014 Lionel HW Lum et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.