Acute Liver Failure with Intracerebral Hemorrhage in Dengue Fever: A Rare Clinical Presentation

Dengue is the major cause of arthropod-borne viral disease in the world. It presents with high fever, headache, rash, myalgia, and arthralgia and it is a self-limiting illness. Severe dengue can occur in some cases resulting in dengue hemorrhagic fever (DHF) and dengue shock syndrome (DSS). We present a case of a young patient aged 25-year-old male who presented with fever, jaundice, decreased urine output for 5 days, and altered mental status for the last 1 day. After investigation, he was diagnosed with dengue fever and later developed sepsis-induced acute liver failure with acute kidney injury. The patient was treated with intravenous antibiotics and hemodialysis. Plasmapheresis was done in view of acute liver failure. Gradually patient condition improved and he gained consciousness. But later on, the patient developed spontaneous intracerebral hemorrhage (ICH) and the patient succumbed to his illness after 2 days of developing ICH. ICH is a very rare and atypical manifestation in the case of severe dengue patients, research for effective treatment is crucial now.