[Dengue infection with fatal ending]

Area of Science:

• Medical Entomology
• Tropical Medicine
• Infectious Diseases

Background:

• Dengue virus infections are increasingly diagnosed in travelers returning from endemic regions.
• Primary dengue virus infection typically does not lead to severe disease, but this case presents a fatal outcome.

Observation:

• A 54-year-old man presented with fever, metabolic acidosis, hemoconcentration, and coagulopathy 6 days after returning from St. Maarten.
• Despite negative dengue antibody tests, dengue virus RNA was detected via PCR.
• The patient's condition rapidly deteriorated, leading to death within 24 hours of admission.

Findings:

• Positive PCR for dengue virus RNA confirmed infection.
• Clinical presentation and laboratory findings indicated severe dengue hemorrhagic fever.
• The absence of detectable antibodies at the time of presentation complicated initial diagnosis.

Implications:

• This case underscores the critical importance of considering dengue virus infection in febrile travelers returning from endemic areas, even with atypical presentations or negative serology.
• Early and accurate diagnosis of severe dengue is crucial for timely management and potentially improving outcomes in travelers.
• Healthcare providers should be aware of the increasing global prevalence of dengue and its potential for severe manifestations in travelers.