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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Bibliographic Details
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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Summary: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.
ISSN:1930-0433