Dengue Fever Presenting as Ischaemic Stroke: A Case Report

Abstract

Several neurological manifestations are common in dengue fever. They are encephalitis, encephalopathy, Guillain Barre Syndrome (GBS), Intracranial haemorrhage, but, ischemic stroke is a rare complication. This is a case report of ischaemic stroke in a patient with dengue fever. A 39-year-old female patient presented to the emergency department with the chief complaints of fever, retro orbital pain since four days, and one episode of seizure on the day of presentation. Examination revealed left homonymous hemianopia. Diagnosis of dengue was made based on Immunoglobulin M (IgM) Enzyme-Linked Immunosorbent Assay (ELISA) positive for dengue. Magnetic Resonance Imaging (MRI) brain showed acute infarcts in right temporal, right occipital and right hippocampal region. Severity of hemianopia decreased as the days progressed and platelet count gradually improved to normal limits within five days. Adequate fluid management was given and the patient was discharged once stable. Anti-platelets were started after two weeks during the follow-up. Examination during follow-up showed decrease in hemianopia to just mild blurring of vision on left gaze. Ischemic stroke is even rarer entity and clinicians should be made aware of these complications.