CASE REPORT article
Front. Med.
Sec. Infectious Diseases: Pathogenesis and Therapy
Volume 12 - 2025 | doi: 10.3389/fmed.2025.1515845
Favorable Outcome in a Patient with Simultaneous Dengue Meningoencephalitis and Wernicke's Thiamine Deficiency
Provisionally accepted
- 1General Medicine, Datta Meghe Institute of Higher Education and Research, Wardha, India
- 2Neurology, Datta Meghe Institute of Higher Education and Research, Wardha, India
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This case describes a 35-year-old male chronic binge drinker who presented with fever associated with confused state and symptoms of acute alcohol withdrawal which included tremors and agitation. His routine investigations revealed pancytopenia with dengue NS1 antigen positive status suggestive of dengue fever. Neurological examination revealed abnormalities, such as nystagmus, ophthalmoplegia and altered mental status, which raised an initial suspicion of alternative diagnosis of Wernicke's encephalopathy (WE). Magnetic resonance imaging (MRI) revealed bilateral thalamic hyperintensities and meningeal enhancements, while the positive dengue status suggested a rare manifestation of dengue meningoencephalitis. However, owing to the history of chronic alcoholism, WE couldn't be completely ruled out. The diagnostic challenge in distinguishing between WE and dengue-associated neurological complications is highlighted by the overlapping symptoms in this case. Also, early administration of thiamine, played a crucial role in managing the patient's condition, emphasising the importance of timely intervention in such complex case scenarios with diagnostic uncertainties.
Keywords: Dengue, Thiamine, dengue meningoencephalitis, Wernicke's encephalopathy, Alcoholism, Fever, Thrombocytopenia
Received: 23 Oct 2024; Accepted: 28 May 2025.
Copyright: © 2025 Toshniwal, Kinkar, Acharya and Kumar. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Saket Satyasham Toshniwal, General Medicine, Datta Meghe Institute of Higher Education and Research, Wardha, India
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