Case Report: Dengue Hemorrhagic Fever with Ischemic Stroke

Am J Trop Med Hyg. 2021 Nov 15;106(2):578-581. doi: 10.4269/ajtmh.21-0618.

Abstract

Several neurological manifestations are recognized in dengue infection, but stroke is a rare complication. We report a case of ischemic stroke in a patient with dengue hemorrhagic fever. A 52-year-old previously healthy male presented with a history of fever for 2 days, and left-sided weakness and numbness of sudden onset. MRI scanning showed a right-sided thalamic lacunar infarct. Diagnosis of dengue fever was made based on leuco-thrombocytopenia, positive dengue nonstructural protein-1 (NS-1) antigen, and positive dengue IgM antibodies. Severity of limb weakness correlated with the critical phase of dengue hemorrhagic fever (DHF). He was discharged home with good recovery from neurological symptoms and disability. Strokes are rare in dengue, and are mainly hemorrhagic strokes related to thrombocytopenia. Ischemic stroke is even rarer. More evidence is needed for confirmation of dengue as a pathogenic mechanism of ischemic stroke.

Publication types

  • Case Reports

MeSH terms

  • Brain / diagnostic imaging
  • Dengue / complications*
  • Dengue / diagnosis
  • Dengue / therapy
  • Fever
  • Humans
  • Ischemic Stroke / diagnostic imaging*
  • Ischemic Stroke / virology*
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged
  • Muscle Weakness / etiology
  • Severe Dengue / complications*
  • Tertiary Care Centers
  • Thrombocytopenia / virology
  • Tomography, X-Ray Computed