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Case Report: Dengue Hemorrhagic Fever with Ischemic Stroke

Basnayake Wasala Mudiyanselage Kumarini Eranthika BasnayakeColombo North Teaching Hospital, Ragama, Sri Lanka;

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Kaluachchi Gamage Samanthi Kumari SomaratneColombo North Teaching Hospital, Ragama, Sri Lanka;

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Chathuri Udeshika GoonetillekeColombo North Teaching Hospital, Ragama, Sri Lanka;

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Pattiniya Markkala Yasoma Indrani TilakaratnaFaculty of Medicine, University of Kelaniya, Ragama, Sri Lanka

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Udaya Kumara RanawakaFaculty of Medicine, University of Kelaniya, Ragama, Sri Lanka

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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.

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Author Notes

Address correspondence to B. W. M. K. E. Basnayake, Ward 21, University Medical Unit, Colombo North Teaching Hospital, Ragama, Sri Lanka. E-mail: kbasnayake89@gmail.com

Financial support: No financial support was sought or secured in relation to this article.

Authors’ addresses: B. W. M. K. E. Basnayake, K. G. S. K. Somaratne, and C. U. Goonetilleke, Colombo North Teaching Hospital, Ragama, Sri Lanka, E-mails: kbasnayake89@gmail.com, ssomaratne123@gmail.com, and chathuri86goonetilleke@gmail.com. P. M. Y. I. Tilakaratna and U. K. Ranawaka, Faculty of Medicine, University of Kelaniya, Ragama, Sri Lanka, E-mails: ythilakaratna@gmail.com and udayaran@yahoo.com.

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