Unusual clinical manifestations of dengue disease – Real or imagined?

Cássia Fernanda Estofolete, Mânlio Tasso de Oliveira Mota, Ana Carolina Bernardes Terzian, Bruno Henrique Gonçalves de Aguiar Milhim, Milene Rocha Ribeiro, Delzi Vinha Nunes, Maria Paula Mourão, Shannan L. Rossi, Mauricio Lacerda Nogueira, Nikos Vasilakis

Research output: Contribution to journalReview articlepeer-review

18 Scopus citations


The disease caused by each of the four serotypes of dengue virus (DENV) have plagued humans since last century. Symptoms of dengue virus (DENV) infection range from asymptomatic to dengue fever (DF) to severe dengue disease (SDD). One third of the world's population lives in regions with active urban DENV transmission, and thousands of serologically naïve travelers visit these areas annually, making a significant portion of the human population at risk of being infected. Even though lifelong immunity to the homotypic serotype is achieved after a primary DENV infection. Heterotypic DENV infections may be exacerbated by a pre-existing immune memory to the primary infection and can result in an increased probability of severe disease. Not only, age, comorbidities and presence of antibodies transferred passively from dengue-immune mother to infants are considered risk factors to dengue severe forms. Plasma leakage and multiple organ impairment are well documented in the literature, affecting liver, lung, brain, muscle, and kidney. However, unusual manifestation, severe or not, have been reported and may require medical attention. This review will summarize and discuss the increasing reports of unusual manifestations in the clinical course of dengue infection.

Original languageEnglish (US)
Article number105134
JournalActa Tropica
StatePublished - Nov 2019


  • Arbovirus
  • Clinical manifestations
  • Dengue
  • Neurologic complications

ASJC Scopus subject areas

  • Parasitology
  • veterinary (miscalleneous)
  • Insect Science
  • Infectious Diseases


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