Dengue hemorrhagic fever and fulminant hepatic failure

Dengue fever is one of the most common arboviral infections worldwide, with about 2.5 million people at risk and an estimated annual incidence of 50 millionto 100 million cases (1, 2). Dengue hemorrhagic fever is a more severe manifestation of dengue fever and is associated with a secondary infection with a different serotype of the virus (2). Atypical and unusual manifestations of dengue are being increasingly reported, including cranial nerve palsies, encephalitis, encephalopathy, parotitis, and cardiomyopathy (2). Although mild to moderate elevations of transaminases are seen in 80-90% of cases of dengue fever (3), fulminant hepatic failure is an uncommon manifestation (4). We report a case of dengue hemorrhagic fever presenting as fulminant hepatic failure, with complete recovery after conservative management.