Case Report: Favorable outcome in a patient with simultaneous dengue meningoencephalitis and Wernicke’s thiamine deficiency

This case report describes the case of a 35-year-old man with a history of chronic binge drinking who presented with fever, associated confused state of mind, and symptoms indicative of acute alcohol withdrawal, including tremors and agitation. Routine investigations revealed pancytopenia and a posi...

Full description

Saved in:
Bibliographic Details
Main Authors: Saket Satyasham Toshniwal, Jiwan S. Kinkar, Sourya Acharya, Sunil Kumar
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-06-01
Series:Frontiers in Medicine
Subjects:
Online Access:https://www.frontiersin.org/articles/10.3389/fmed.2025.1515845/full
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1850103678602575872
author Saket Satyasham Toshniwal
Jiwan S. Kinkar
Sourya Acharya
Sunil Kumar
author_facet Saket Satyasham Toshniwal
Jiwan S. Kinkar
Sourya Acharya
Sunil Kumar
author_sort Saket Satyasham Toshniwal
collection DOAJ
description This case report describes the case of a 35-year-old man with a history of chronic binge drinking who presented with fever, associated confused state of mind, and symptoms indicative of acute alcohol withdrawal, including tremors and agitation. Routine investigations revealed pancytopenia and a positive dengue NS1 antigen test, confirming a diagnosis of dengue fever. Neurological examination revealed abnormalities, such as nystagmus, ophthalmoplegia, and altered mental status, which raised the initial suspicion of an alternative diagnosis of Wernicke’s encephalopathy (WE). Magnetic resonance imaging (MRI) revealed bilateral thalamic hyperintensities and meningeal enhancement, while the positive dengue status revealed a rare manifestation of dengue meningoencephalitis. However, owing to the patient’s history of chronic alcoholism, WE could not 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. Furthermore, early administration of thiamine played a crucial role in managing the patient’s condition, highlighting the importance of timely intervention in such complex cases marked by diagnostic uncertainties.
format Article
id doaj-art-bd6fb879987d4165a2f53b072736ebdb
institution DOAJ
issn 2296-858X
language English
publishDate 2025-06-01
publisher Frontiers Media S.A.
record_format Article
series Frontiers in Medicine
spelling doaj-art-bd6fb879987d4165a2f53b072736ebdb2025-08-20T02:39:29ZengFrontiers Media S.A.Frontiers in Medicine2296-858X2025-06-011210.3389/fmed.2025.15158451515845Case Report: Favorable outcome in a patient with simultaneous dengue meningoencephalitis and Wernicke’s thiamine deficiencySaket Satyasham Toshniwal0Jiwan S. Kinkar1Sourya Acharya2Sunil Kumar3Department of General Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IndiaDepartment of Neurology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IndiaDepartment of General Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IndiaDepartment of General Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IndiaThis case report describes the case of a 35-year-old man with a history of chronic binge drinking who presented with fever, associated confused state of mind, and symptoms indicative of acute alcohol withdrawal, including tremors and agitation. Routine investigations revealed pancytopenia and a positive dengue NS1 antigen test, confirming a diagnosis of dengue fever. Neurological examination revealed abnormalities, such as nystagmus, ophthalmoplegia, and altered mental status, which raised the initial suspicion of an alternative diagnosis of Wernicke’s encephalopathy (WE). Magnetic resonance imaging (MRI) revealed bilateral thalamic hyperintensities and meningeal enhancement, while the positive dengue status revealed a rare manifestation of dengue meningoencephalitis. However, owing to the patient’s history of chronic alcoholism, WE could not 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. Furthermore, early administration of thiamine played a crucial role in managing the patient’s condition, highlighting the importance of timely intervention in such complex cases marked by diagnostic uncertainties.https://www.frontiersin.org/articles/10.3389/fmed.2025.1515845/fulldenguethiaminedengue meningoencephalitisWernicke’s encephalopathyalcoholismfever
spellingShingle Saket Satyasham Toshniwal
Jiwan S. Kinkar
Sourya Acharya
Sunil Kumar
Case Report: Favorable outcome in a patient with simultaneous dengue meningoencephalitis and Wernicke’s thiamine deficiency
Frontiers in Medicine
dengue
thiamine
dengue meningoencephalitis
Wernicke’s encephalopathy
alcoholism
fever
title Case Report: Favorable outcome in a patient with simultaneous dengue meningoencephalitis and Wernicke’s thiamine deficiency
title_full Case Report: Favorable outcome in a patient with simultaneous dengue meningoencephalitis and Wernicke’s thiamine deficiency
title_fullStr Case Report: Favorable outcome in a patient with simultaneous dengue meningoencephalitis and Wernicke’s thiamine deficiency
title_full_unstemmed Case Report: Favorable outcome in a patient with simultaneous dengue meningoencephalitis and Wernicke’s thiamine deficiency
title_short Case Report: Favorable outcome in a patient with simultaneous dengue meningoencephalitis and Wernicke’s thiamine deficiency
title_sort case report favorable outcome in a patient with simultaneous dengue meningoencephalitis and wernicke s thiamine deficiency
topic dengue
thiamine
dengue meningoencephalitis
Wernicke’s encephalopathy
alcoholism
fever
url https://www.frontiersin.org/articles/10.3389/fmed.2025.1515845/full
work_keys_str_mv AT saketsatyashamtoshniwal casereportfavorableoutcomeinapatientwithsimultaneousdenguemeningoencephalitisandwernickesthiaminedeficiency
AT jiwanskinkar casereportfavorableoutcomeinapatientwithsimultaneousdenguemeningoencephalitisandwernickesthiaminedeficiency
AT souryaacharya casereportfavorableoutcomeinapatientwithsimultaneousdenguemeningoencephalitisandwernickesthiaminedeficiency
AT sunilkumar casereportfavorableoutcomeinapatientwithsimultaneousdenguemeningoencephalitisandwernickesthiaminedeficiency