Dengue fever complicated by abscess formation: An atypical presentation

Abstract: Dengue fever is a mosquito-borne disease with a wide clinical spectrum, ranging from self-limiting mild sickness to expanded dengue syndrome (EDS). Despite extensive investigation into the immunological pathogenesis of dengue virus (DENV) infection, the precise mechanism remains unclear. DENV’s transitory reduction of host innate immunity could be the most likely cause of dengue-associated coinfections and/or superinfections. Furthermore, the dual infection can aggravate the clinical course of dengue fever. We document an unusual case of dengue fever in a 27-year-old healthy male, exacerbated by cellulitis and myositis involving the posterolateral compartment of the proximal and midcalf, which was later discovered to be an abscess. Blood culture showed methicillin-sensitive Staphylococcus aureus . This case shows the possibility of bacterial coinfections in dengue patients, especially in the context of immunosuppression, as well as the need for early recognition of atypical characteristics and the novel entity known as EDS.