CASE REPORT:
A 56-year-old male presented with a 3 days history of intermittent fever with associated non-productive cough. The fever temporarily subsided on taking medications. The patient also had headaches described as, generalized, pricking, and continuous. He has no history of syncope, palpitations, chest pain, shortness of breath, or any cardio-pulmonary symptoms. The patient is diabetic, hypertensive, and non-compliant with medications. The patient does not have a family history of sudden cardiac death or any cardiac diseases. He has no significant past medical or surgical history. This case has been reported in line with the SCARE criteria (4)..
On physical examination, the patient was febrile (102.7F), and tachycardic, otherwise, the findings were unremarkable. The laboratory findings showed positive for Dengue NS1 antigen and IgM , with a platelet count of 187× 103 /μL.
The patient was admitted and managed with intravenous fluids, broad-spectrum antibiotics, and acetaminophen. On the evening of admission, the complete blood count was repeated, showing a platelet count of 29 × 103 /μL, hematocrit 45.4%, hemoglobin 15.8g/dL, WBC 8.24 × 103 /μL, and lymphocytes 60.2% with suspected thrombocytopenia, large immature cells, and atypical cells. On day 2 of admission complete blood count showed a platelet count of 26 × 103 /μL, hematocrit 42.6%, hemoglobin 14.8g/dL, WBC 8.56× 103 /μL, and lymphocytes 65.2% with suspected thrombocytopenia, lymphocytosis, and large immature cells. Serum electrolytes, urea, and creatinine were all within the normal range.