Neurological manifestations as presenting feature in dengue Fever

Dengue fever (DF), caused by dengue viruses, presents classic dengue fever, dengue hemorrhagic fever, and dengue shock syndrome. A young man presented with 5 days history of fever, body aches, headache, vomiting and one day history of drowsiness and a generalized tonic clonic fit. He was afebrile and hypotensive with platelets count of 24 x 109/l, and serum IgM DENV positive. Computerized tomography scan of the brain revealed intracerebral haemorrhages in both cerebral hemispheres. He was managed with supportive care and 20% mannitol infusion, his headache and drowsiness rapidly improved. Platelet count rose to 60 x 109/l on 2nd day and 199 x 109/l on 7th day of admission. He remained afebrile during hospital stay and was discharged from hospital on 8th day of admission, when he was almost asymptomatic.