Different Presentations of Expanded Dengue Syndrome: A Case Series and Review of Literature

Abstract

A bstrAct Expanded dengue syndrome (EDS) is an atypical presentation of dengue fever with the involvement of various organ systems. We present five cases of EDS with varying features. The first and second patients had concurrent infection with falciparum malaria and vivax malaria, respectively, which made the diagnosis and treatment challenging. The third patient had coinfection with scrub typhus. The fourth patient was diagnosed with long-segment myelitis of the brain stem. The final patient in this series had a rare presentation consistent with post dengue hemophagocytic lymphohistocytosis (secondary HLH). There is no direct correlation between the severity of dengue and the type of organ involvement, and even without the classical features of dengue, serious complications can arise. In conclusion, it is of utmost importance to have a high index of suspicion and be well-informed of the different presentations and coinfections associated with EDS.