Pancreatitis as a Rare Complication of Dengue Fever: A Case Report and Review of the Literature

Dengue fever is a prevalent mosquito-borne viral infection in tropical and subtropical regions. High-grade fever, myalgia, arthralgia, and hemorrhagic manifestations are among its classic clinical features. Acute pancreatitis, however, remains an exceptionally rare complication. Awareness of this possibility is crucial, as early recognition and appropriate management can significantly improve patient outcomes. A previously healthy 44-year-old woman presented with a five-day history of severe epigastric pain radiating to the back, high-grade fever (39°C), profuse sweating, and persistent greenish vomiting. Laboratory results revealed leukopenia, elevated liver enzymes, and markedly raised pancreatic enzymes (amylase and lipase). Dengue infection was confirmed by polymerase chain reaction. Imaging demonstrated minimal biliary sludge and mild pancreatic edema without evidence of gallstones or necrosis. She was managed supportively with intravenous fluids, analgesics, and antiemetics, and her condition improved rapidly. By the fourth day of hospitalization, she was discharged in stable condition with dietary advice. Acute pancreatitis complicating dengue is rarely reported, with proposed mechanisms involving direct viral invasion, immune-mediated damage, or ischemic injury from increased vascular permeability. This case underscores the need to consider pancreatitis in patients with dengue who experience severe or persistent abdominal pain. A high index of suspicion is paramount to ensure early diagnosis, prompt supportive treatment, and favorable patient outcomes. This report highlights acute pancreatitis as a rare but important complication of dengue fever. Clinicians practicing in dengue-endemic areas should maintain vigilance for this diagnosis to facilitate early intervention. Strengthening physician awareness may influence guidelines and promote more timely identification of this unusual yet significant complication.