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BMJ Case Rep. 2010; 2010: bcr06.2009.1949.
Published online 2010 January 13. doi:  10.1136/bcr.06.2009.1949
PMCID: PMC3029086
Unusual association of diseases/symptoms

Skin rash, headache and abnormal behaviour: unusual presentation of intracranial haemorrhage in dengue fever


Dengue viral infections are one of the most important mosquito borne diseases in the world. The dengue virus is a single stranded RNA virus belonging to the Flaviviridae family. There are four serotypes (DEN 1–4) classified according to biological and immunological criteria. Patients may be asymptomatic or their condition may give rise to undifferentiated fever, dengue fever, dengue haemorrhagic fever (DHF), or dengue shock syndrome. Annually, 100 million cases of dengue fever and half a million cases of DHF occur worldwide and 2.5 billion people are at risk. At present, dengue is endemic in 112 countries. Early recognition and prompt initiation of appropriate treatment are vital if disease related morbidity and mortality are to be limited. We present an interesting case of dengue fever with headache, skin rash and abnormal behaviour who had a massive intracranial haemorrhage with fatal outcome.

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