{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T16:05:28Z","timestamp":1753891528253,"version":"3.41.2"},"reference-count":11,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,6,17]],"date-time":"2025-06-17T00:00:00Z","timestamp":1750118400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:p>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\u2019s 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\u2019s 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\u2019s condition, highlighting the importance of timely intervention in such complex cases marked by diagnostic uncertainties.<\/jats:p>","DOI":"10.3389\/fmed.2025.1515845","type":"journal-article","created":{"date-parts":[[2025,6,17]],"date-time":"2025-06-17T05:28:07Z","timestamp":1750138087000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Case Report: Favorable outcome in a patient with simultaneous dengue meningoencephalitis and Wernicke\u2019s thiamine deficiency"],"prefix":"10.3389","volume":"12","author":[{"given":"Saket Satyasham","family":"Toshniwal","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jiwan S.","family":"Kinkar","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sourya","family":"Acharya","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sunil","family":"Kumar","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2025,6,17]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"319","DOI":"10.1186\/s12879-024-09198-z","article-title":"Dengue encephalopathy in an adult due to dengue virus type 1 infection","volume":"24","author":"Leng","year":"2024","journal-title":"BMC Infect Dis"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"48","DOI":"10.1016\/j.genhosppsych.2024.01.005","article-title":"Diagnosis and treatment of Wernicke's encephalopathy: a systematic literature review","volume":"87","author":"Cantu-Weinstein","year":"2024","journal-title":"Gen Hosp Psychiatry"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"585","DOI":"10.4103\/0028-3886.68655","article-title":"Encephalitis in the clinical spectrum of dengue infection","volume":"58","author":"Varatharaj","year":"2010","journal-title":"Neurol India"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"830","DOI":"10.1093\/brain\/awad415","article-title":"Dengue virus infection and neurological manifestations: an update","volume":"147","author":"Fong","year":"2024","journal-title":"Brain"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"809","DOI":"10.1007\/s11604-020-00989-3","article-title":"Comprehensive review of Wernicke encephalopathy: pathophysiology, clinical symptoms and imaging findings","volume":"38","author":"Ota","year":"2020","journal-title":"Jpn J Radiol"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"265","DOI":"10.1186\/s12883-020-01834-w","article-title":"Bilateral thalamic lesions in a patient with probable acute disseminating encephalomyelitis: a case report","volume":"20","author":"Zheng","year":"2020","journal-title":"BMC Neurol"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"236","DOI":"10.1186\/s13054-021-03659-6","article-title":"Infectious disease-associated encephalopathies","volume":"25","author":"Barbosa-Silva","year":"2021","journal-title":"Crit Care"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"2045125320978106","DOI":"10.1177\/2045125320978106","article-title":"Wernicke's encephalopathy\u2014from basic science to clinical practice. Part 1: understanding the role of thiamine","volume":"10","author":"Ott","year":"2020","journal-title":"Ther Adv Psychopharmacol"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"33","DOI":"10.1016\/j.clnu.2021.10.021","article-title":"Clinical diagnosis, outcomes and treatment of thiamine deficiency in a tertiary hospital","volume":"41","author":"Mifsud","year":"2022","journal-title":"Clin Nutr"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"1038","DOI":"10.4103\/0028-3886.294556","article-title":"Pattern recognition approach to brain MRI findings in patients with dengue fever with neurological complications","volume":"68","author":"Vyas","year":"2020","journal-title":"Neurol India"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"3916","DOI":"10.1093\/brain\/awac219","article-title":"The Wernicke conundrum revisited: evidence from connectome-based lesion-symptom mapping","volume":"145","author":"Matchin","year":"2022","journal-title":"Brain"}],"container-title":["Frontiers in Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2025.1515845\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,6,17]],"date-time":"2025-06-17T05:28:08Z","timestamp":1750138088000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2025.1515845\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,6,17]]},"references-count":11,"alternative-id":["10.3389\/fmed.2025.1515845"],"URL":"https:\/\/doi.org\/10.3389\/fmed.2025.1515845","relation":{},"ISSN":["2296-858X"],"issn-type":[{"type":"electronic","value":"2296-858X"}],"subject":[],"published":{"date-parts":[[2025,6,17]]},"article-number":"1515845"}}