CNS hemorrhage as clinical manifestation of dengue

How to cite this article:
Joob B, Wiwanitkit V, Err H. CNS hemorrhage as clinical manifestation of dengue. Ann Trop Med Public Health 2014;7:151-2


How to cite this URL:
Joob B, Wiwanitkit V, Err H. CNS hemorrhage as clinical manifestation of dengue. Ann Trop Med Public Health [serial online] 2014 [cited 2017 Nov 14];7:151-2. Available from:

Dear Sir,

Dengue is an important tropical infection. Hemorrhage is an important clinical problem in the course of dengue infection. Hemorrhage can manifest at any organs. Brain hemorrhage in dengue is very interesting. In fact, the involvement of brain in dengue is possible and usually forgotten. It is the emerging concern in management of dengue. Brain hemorrhage is included in expanded dengue syndrome. [1],[2] The profound thrombocytopenia is mentioned as the cause of brain hemorrhage and the spontaneous resolution when dengue illness is improved can be expected. [1],[2] Kumar et al., noted that this condition has to be kept in mind “in those patients who are disoriented and have altered sensorium”. [3] However, the occurrence of brain hemorrhage in the case with dengue shock can be serious and leads to death. [4] The occurrence of brainstem hemorrhage can be a very serious fatal situation. [5] Focusing on fatal dengue cases, the brain hemorrhage is a common finding. [6] It is advisable that the regular evaluation of neurological signs and symptoms in any dengue patients should be done since early detection and management of the possible neurological complication can result in good outcome.



Assir MZ, Jawa A, Ahmed HI. Expanded dengue syndrome: Subacute thyroiditis and intracerebral hemorrhage. BMC Infect Dis 2012;12:240.
Wiwanitkit V. Dengue fever: Diagnosis and treatment. Expert Rev Anti Infect Ther 2010;8:841-5.
Kumar R, Prakash O, Sharma BS. Intracranial hemorrhage in dengue fever: Management and outcome: A series of 5 cases and review of literature. Surg Neurol 2009;72:429-33.
Jain N, Gutch M, Kumar V, Naik AK. A fatal combo of dengue shock syndrome with acute subdural hematoma. Neurol India 2012; 60:105-6.
Singh M, Garg K, Bisht A, Sharma BS, Singh PK, Pandia M, et al. Spinal epidural hematoma with myelitis and brainstem hemorrhage: An unusual complication of dengue fever. Neurol India 2013; 61:541-3.
Wiwanitkit V. Magnitude and pattern of neurological pathology in fatal dengue hemorrhagic fever: A summary of Thai cases. Neuropathology 2005;25:398.

Source of Support: None, Conflict of Interest: None


DOI: 10.4103/1755-6783.146455

Paul Mies has now been involved with test reports and comparing products for a decade. He is a highly sought-after specialist in these areas as well as in general health and nutrition advice. With this expertise and the team behind, they test, compare and report on all sought-after products on the Internet around the topics of health, slimming, beauty and more. The results are ultimately summarized and disclosed to readers.


Please enter your comment!
Please enter your name here