School of Medicine Publications and Presentations
Document Type
Article
Publication Date
8-31-2025
Abstract
Dengue virus infection is increasingly recognized in South Texas, particularly in areas bordering Mexico. Although many cases are mild and self-limiting, dengue can present with atypical features, including hematological abnormalities and bleeding, even in the absence of plasma leakage. A 22-year-old Hispanic woman presented to a hospital in South Texas with hematemesis, fever, and gastrointestinal symptoms following travel to northeastern Mexico (Monterrey, Nuevo Leon). Initial laboratory workup revealed severe leukopenia and neutropenia, mild thrombocytopenia, and elevated liver enzymes, but no evidence of plasma leakage. A bone marrow biopsy was performed due to persistent cytopenias, revealing a reactive process consistent with viral infection. The patient improved with supportive care, including hydration, antipyretics, and symptom management, which reflects the mainstay of dengue management. This case illustrates an atypical dengue presentation marked by hematological derangements without classic features, such as hemoconcentration or plasma leakage. It underscores the diagnostic challenge dengue poses in non-typical cases, the importance of maintaining clinical suspicion in endemic areas, and the need for judicious use of invasive investigations and blood product support. Dengue may present atypically with severe cytopenias and bleeding without plasma leakage. Clinicians in endemic areas such as South Texas should consider dengue in febrile patients with cytopenias, even in the absence of plasma leakage, and avoid unnecessary interventions when supportive care suffices.
Recommended Citation
Arellano Villanueva, E., Asaad, A., & Campo Maldonado, J. E. (2025). Atypical Dengue Fever Presentation With Severe Leukopenia: A Case Report From an Endemic Border Region. Cureus, 17(8), e91359. https://doi.org/10.7759/cureus.91359
Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License.
Publication Title
Cureus
DOI
10.7759/cureus.91359
Academic Level
faculty
Mentor/PI Department
Internal Medicine
Comments
Copyright © 2025, Arellano Villanueva et al.
This is an open access article distributed under the terms of the Creative Commons Attribution License CC-BY 4.0., which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.