SHM Converge Scientific Abstract ePoster Gallery-A Case of Dengue Hemorrhagic Fever

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This case describes a 46-year-old woman who developed dengue hemorrhagic fever after returning from a two-week trip to Mexico, where she reported mosquito exposure. She presented with five days of fever, myalgias, headache, and a week of intermittent epistaxis and gingival bleeding. On exam, she had scattered petechiae on both lower legs but was otherwise hemodynamically stable.<br /><br />Laboratory testing showed severe thrombocytopenia with platelets of 20, along with elevated liver enzymes, low albumin, and low total protein. CT imaging demonstrated periportal edema and small ascites, suggesting hepatitis and plasma leakage. Because of her travel history and compatible symptoms, a broad infectious workup was performed, including dengue, chikungunya, Zika, CMV, tick-borne disease, viral hepatitis, and HIV. Dengue NS1 antigen and PCR were positive, IgG was positive, and IgM was equivocal; all other tests were negative.<br /><br />She was diagnosed with dengue hemorrhagic fever based on the combination of fever, mucocutaneous bleeding, severe thrombocytopenia, and evidence of increased vascular permeability. Management was supportive, with intravenous fluids to maintain euvolemia and close monitoring of platelets and liver tests. She improved steadily, remained afebrile, and her platelet count rose to 125 by hospital day 5. She was discharged in stable condition and was well at one-week follow-up, with normalization of CBC and liver function tests.<br /><br />The report emphasizes that dengue should be considered in patients with acute febrile illness and recent travel to endemic areas. Warning signs of severe dengue include plasma leakage, bleeding, thrombocytopenia, shock, and organ dysfunction. Inpatient monitoring is important when these features are present.

Asset Subtitle

Alex Danielson

Meta Tag

Author List Alex Danielson, Shafay Raheel

Category Clinical Vignettes

Concept Dengue Hemorrhagic Fever

Concept Plasma Leakage

Concept Thrombocytopenia

Concept NS1 Antigen

Concept Supportive Care

Distinguished Non-Finalist

Presenter Organization Mayo Clinic Rochester

Presenting Author Alex Danielson

Track Adult

Keywords

dengue hemorrhagic fever

thrombocytopenia

mosquito exposure

Mexico travel

epistaxis

gingival bleeding

plasma leakage

NS1 antigen

PCR positive

supportive care

Dengue Hemorrhagic Fever

Plasma Leakage

Thrombocytopenia

NS1 Antigen

Supportive Care