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Case Report: Dengue Hemorrhagic Fever with Ischemic Stroke
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
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.