Abstract
Dengue viral infections are increasing in number globally as more travellers are being exposed to the vector in endemic areas. A 41-year-old previously-well woman is reported who died suddenly and unexpectedly from dengue fever following a holiday overseas. Clinical manifestations prior to her collapse were non-specific, consisting of headaches, fever and diarrhoea. The autopsy findings were also non-specific with no skin rash or evidence of coagulopathy. A rapid immunodiffusion assay for dengue NS1 antigen, however, gave a rapid and strong reaction on two occasions and real-time polymerase chain reaction (RT-PCR) testing on a post-mortem blood sample confirmed the presence of flavivirus RNA identified as dengue type 1. This case demonstrates the possibility of serious dengue infections being associated with recent international travel. The non-specificity of symptoms, signs and autopsy findings, combined with its occurrence in non-endemic areas, makes a heightened awareness of this condition important in contemporary forensic settings.
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