Multisystem Complications of Dengue Encephalitis: Addressing Hemophagocytic Lymphohistiocytosis (HLH) – A Case Report

Dengue encephalitis is uncommon as neurological involvement is a rare complication of dengue fever. Neurological hematological and cardiac manifestations can occur presenting a challenging clinical scenario. This report describes an elderly female with a decade-long history of type 2 diabetes mellitus who presented with dengue encephalitis complicated by hemophagocytic lymphohistiocytosis HLH and cardiac arrhythmias. The initial symptoms led to a diagnosis of dengue encephalitis confirmed by positive dengue IgM and MRI brain findings. Her condition subsequently deteriorated necessitating recurrent hospitalizations and the development of both supraventricular and ventricular tachycardia requiring advanced cardiac life support ACLS. Despite intensive care and clinical stabilization persistently elevated inflammatory markers including elevated C-reactive protein CRP indicated ongoing systemic inflammation. This case highlights the complexities involved in managing severe dengue infection in elderly diabetic patients.