Abstract
BackgroundArboviruses are a common cause of fever in the returned traveler often associated with leucopenia, especially lymphopenia and thrombocytopenia. Transient neutropenia has been described in a few cases of arboviruses. However, prolonged and severe neutropenia (<500/mm3) has rarely been reported in dengue fever, especially in the returned traveler in Europe.Case presentationA 26-year-old healthy female without any medical past history, flying back from Thailand, presented a transient fever with severe neutropenia (<500/mm3). Laboratory tests showed a mild hepatic cytolysis and thrombocytopenia, mimicking malaria or viral hepatitis. While she underwent protective isolation, NS1 antigen returned positive in favor of a dengue fever. Outcome was favorable without any antimicrobial therapy.ConclusionPhysicians should be wary of possible unusual presentation of dengue fever with prolonged neutropenia. Although such biological sign is more often associated with malaria or severe bacterial infection, it may be a sign of arbovirus.
Highlights
Arboviruses are a common cause of fever in the returned traveler often associated with leucopenia, especially lymphopenia and thrombocytopenia
Physicians should be wary of possible unusual presentation of dengue fever with prolonged neutropenia
Such biological sign is more often associated with malaria or severe bacterial infection, it may be a sign of arbovirus
Summary
While neutropenia is commonly encountered in arboviruses’ endemic countries, such biological sign is more often associated with malaria or severe bacterial infection. Severe neutropenia may still be a sign of authentic arbovirus. Physicians should be wary of possible unusual presentation with prolonged neutropenia. Authors’ contributions BD and JS designed the report. MM supervised data collection and data management. BD, MM and JSh analyzed the data. JS, BD and MM prepared the 1st draft of the manuscript. All the authors participated in manuscript preparation. All authors read and approved the final manuscript
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