Severe dengue encephalitis showcasing the “double doughnut sign” on MRI: A case report

Severe dengue can lead to fatal complications, including dengue encephalitis. We report a 14-year-old girl with severe dengue who presented with bilateral thalamic hemorrhagic infarction, indicated by distinct brain imaging findings (the so-called “double doughnut sign”), which is a rare presentatio...

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Main Authors: Salhadin Mohammed, Aman Edao Bime, China Tolessa Sedi, Hussen Nuri Saliha, Surafel Tilahun Maru, Abdulfatah Workicho Mustafa
Format: Article
Language:English
Published: Elsevier 2025-09-01
Series:Radiology Case Reports
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Online Access:http://www.sciencedirect.com/science/article/pii/S1930043325005898
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author Salhadin Mohammed
Aman Edao Bime
China Tolessa Sedi
Hussen Nuri Saliha
Surafel Tilahun Maru
Abdulfatah Workicho Mustafa
author_facet Salhadin Mohammed
Aman Edao Bime
China Tolessa Sedi
Hussen Nuri Saliha
Surafel Tilahun Maru
Abdulfatah Workicho Mustafa
author_sort Salhadin Mohammed
collection DOAJ
description Severe dengue can lead to fatal complications, including dengue encephalitis. We report a 14-year-old girl with severe dengue who presented with bilateral thalamic hemorrhagic infarction, indicated by distinct brain imaging findings (the so-called “double doughnut sign”), which is a rare presentation of a common infection. Positive dengue antigen and IgM tests were noted. The patient required critical care, including intubation and resuscitation, but was discharged improved and continues follow-up at our neurology clinic. This case highlights that dengue infection can be complicated by meningoencephalitis, and a high index of suspicion is needed to diagnose our patients promptly. Furthermore, imaging modalities such as MRI play a key role in diagnosing and managing patients with dengue encephalitis.
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publisher Elsevier
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series Radiology Case Reports
spelling doaj-art-a31e25ccc5a24fe7b1fdc9cda45ee6db2025-08-20T02:36:46ZengElsevierRadiology Case Reports1930-04332025-09-012094820482410.1016/j.radcr.2025.06.043Severe dengue encephalitis showcasing the “double doughnut sign” on MRI: A case reportSalhadin Mohammed0Aman Edao Bime1China Tolessa Sedi2Hussen Nuri Saliha3Surafel Tilahun Maru4Abdulfatah Workicho Mustafa5Internal Medicine Department, Division of Neurology, School of Medicine, College of Health Sciences, Wollo University, Dessie, Ethiopia; Corresponding authors.Anaesthesiology, Critical Care, and Pain Medicine Department, School of Medicine, College of Health Sciences, Haramaya University, Harar, EthiopiaNeurosurgery Department, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, EthiopiaNeurology Department, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, EthiopiaNeurology Department, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, EthiopiaRadiology Department, School of Medicine, College of Health Sciences, University of Gondar Comprehensive Specialized Hospital, Gondar, Ethiopia; Corresponding authors.Severe dengue can lead to fatal complications, including dengue encephalitis. We report a 14-year-old girl with severe dengue who presented with bilateral thalamic hemorrhagic infarction, indicated by distinct brain imaging findings (the so-called “double doughnut sign”), which is a rare presentation of a common infection. Positive dengue antigen and IgM tests were noted. The patient required critical care, including intubation and resuscitation, but was discharged improved and continues follow-up at our neurology clinic. This case highlights that dengue infection can be complicated by meningoencephalitis, and a high index of suspicion is needed to diagnose our patients promptly. Furthermore, imaging modalities such as MRI play a key role in diagnosing and managing patients with dengue encephalitis.http://www.sciencedirect.com/science/article/pii/S1930043325005898Severe dengueDengue encephalitisDouble doughnut signMRICase report
spellingShingle Salhadin Mohammed
Aman Edao Bime
China Tolessa Sedi
Hussen Nuri Saliha
Surafel Tilahun Maru
Abdulfatah Workicho Mustafa
Severe dengue encephalitis showcasing the “double doughnut sign” on MRI: A case report
Radiology Case Reports
Severe dengue
Dengue encephalitis
Double doughnut sign
MRI
Case report
title Severe dengue encephalitis showcasing the “double doughnut sign” on MRI: A case report
title_full Severe dengue encephalitis showcasing the “double doughnut sign” on MRI: A case report
title_fullStr Severe dengue encephalitis showcasing the “double doughnut sign” on MRI: A case report
title_full_unstemmed Severe dengue encephalitis showcasing the “double doughnut sign” on MRI: A case report
title_short Severe dengue encephalitis showcasing the “double doughnut sign” on MRI: A case report
title_sort severe dengue encephalitis showcasing the double doughnut sign on mri a case report
topic Severe dengue
Dengue encephalitis
Double doughnut sign
MRI
Case report
url http://www.sciencedirect.com/science/article/pii/S1930043325005898
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