Bilateral eyelid ecchymosis and subconjunctival haemorrhage manifesting as presenting feature in a case of dengue haemorrhagic fever

Abstract

We report a case of bilateral eyelid ecchymosis and subconjunctival haemorrhage, a rare presenting feature of dengue haemorrhagic fever. A 17-year-old boy presented to the emergency department with complaints of redness in both eyes and vomiting. He had bilateral eyelid ecchymosis with subconjunctival haemorrhage. Complete blood count revealed a significantly reduced platelet count of 11000/µL suggestive of dengue haemorrhagic fever (DHF). Ocular manifestations were followed by other systemic haemorrhagic manifestations of dengue later on which violates the usual sequence of events of dengue fever. Bilateral eyelid ecchymosis is a rare clinical manifestation and a rare presenting feature of dengue fever and one has to keep high index of suspicion for presence of dengue whenever a case of fever presents with lid ecchymosis/haemorrhage.

Dermatologic Vasculature Diseases as a Risk Factor of Subconjunctival Hemorrhage

“…Diabetes mellitus has a similar trend. [5] In addition, SCH has been observed in patients with coagulopathies, including uremic syndrome, dengue hemorrhagic fever, leptospirosis, and use of anticoagulation agents [8,9,10,11]. Also, diseases that interrupt vascular structures like Steve-Johnson syndrome and hemochromatosis have been reported to present as SCH [12,13].…”