Encephalitis & hemophagocytic lymphohistiocytosis secondary to dengue hemorrhagic fever: A case report

Hemophagocytic lymphohistiocytosis (HLH)1 is a fatal disease that may occur as a primary inherited or secondary due to several causes, including infections such as dengue. Encephalitis and encephalopathy are the most common neurological presentations of dengue. A 17-year-old female, after the critical period of dengue, developed tachycardia, rigidity, deteriorating consciousness level, seizures, and stereotyped movements. Fever did not remit and was subsequently diagnosed as HLH with ferritin more than 30,000 ng/mL and treated with steroids. This case report describes a patient who survived despite having an unusual combination of dengue hemorrhagic fever, encephalitis, and HLH.