A Case of Dengue Meningitis Manifested as a Part of Expanded Dengue Syndrome

Abstract

Dengue is a prevalent arthropod-borne viral disease in tropical and subtropical areas of the globe. Dengue clinical manifestations include asymptomatic infections; undifferentiated fever; dengue fever, which is characterized by fever, headache, retro orbital pain, myalgia, and arthralgia; and a severe form of the disease denominated dengue hemorrhagic fever/dengue shock syndrome, characterized by hemoconcentration, thrombocytopenia, and bleeding tendency. However, atypical manifestations, such as liver, central nervous system, and cardiac involvement, have been increasingly reported called expanded dengue syndrome. We report a 35 years old lady with atypical and rare presentation of dengue disease marked by meningitis. Condition improved after conservative treatment. Neurological complications in dengue are now increasingly observed with the most common case is aseptic meningitis. Dengue meningitis is self-limiting in almost all cases. Hepatic failure rarely dominates the clinical picture in adults. The main mechanism of dengue meningitis is still unknown though both direct viral infection and immune mediated damage have been suggested to be the cause. To avoid otherwise preventable morbidity and mortality, physicians should have a high index of suspicion for neurological complications in patients with dengue illness and should manage this accordingly