Case report demonstrates fatal hemorrhagic fever from dengue and avian orthoavulavirus 1 coinfection in a returning traveler, highlighting cross-species viral threats.
A previously healthy 26-year-old man died of hemorrhagic fever with fulminant hepatitis and shock 36 hours after returning to France from Mecca, Saudi Arabia. Postmortem analyses detected low-level dengue virus RNA and positive NS1 antigen along with unexpected extremely high-titer disseminated velogenic avian orthoavulavirus 1 infection with elevated systemic cytokine responses.
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