DR. ANUP KUMAR GOSWAMI

Dr.Nidhi

Abstract

A 17-year-old boy presented to emergency deptt with complaints of redness in both eyes and vomiting.Eye examination showed bilateral eyelid ecchymosis with subconjunctival haemorrhage.Complete blood count revealed significantly reduced platelet count of 11000/mL suggestive of dengue haemorrhagic fever (DHF). Ocular manifestations were followed by other systemic haemorrhagic manifestations of dengue fever which violates the usual sequence of events.Clinical features of DHF include thrombocytopenia associated gum bleeding, epistaxis,gastrointestinal haemorrhage,haematuria and skin petechiae/purpura.Dengue as a cause for eyelid ecchymosis and subconjunctival haemorrhage is usually not considered. Bilateral eyelid ecchymosis/suconjunctival haemorrhage is a rare clinical manifestation and a rarer presenting feature of dengue fever.One has to keep high index of suspicion for presence of DHF whenever a case of fever presents with lid ecchymosis/subconjunctival haemorrhage.