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Dengue Infection: Not Just Fever—A Rare Presentation with Literature Review

Dengue fever is a common viral infection in the tropical areas, especially in India. However, dengue infection presenting as hemorrhagic encephalitis is rare. A 10-year-old girl presented with fever, headache, vomiting, and seizures followed by altered sensorium. Her blood serum was positive for antidengue immunoglobulin M enzyme-linked immunosorbent assay (ELISA) and NS1Ag, and cerebrospinal fluid study showed lymphocytic pleocytosis. Magnetic resonance imaging T2-weighted and fluid-attenuated inversion recovery (FLAIR) images showed hyperintensities involving the bilateral thalami, pons, and midbrain with patchy hemorrhage. Despite all supportive measures, she expired 3 days after admission. Our case highlights that dengue encephalitis may present even in the absence of other classical signs.