• Marije K Bomers, Kamilla D Lettinga, Eric C M van Gorp, Byron E E Martina, Paul G H Peerbooms, and Jan Veenstra.
• Sint Lucas Andreas Ziekenhuis, afd. Interne Geneeskunde, Amsterdam.
• Ned Tijdschr Geneeskd. 2009 Jan 1;153:A725.

AbstractA 54-year-old man was admitted with fever following a trip to St. Maarten in the Dutch Antilles, from where he had returned 6 days earlier. One year prior to this he had been treated on an Intensive Care Unit for a severe influenza A infection. Physical examination revealed remarkably cold extremities, furthermore there was metabolic acidosis, extreme haemoconcentration, prolongation of prothrombin time and activated partial thromboplastin time. His clinical condition deteriorated rapidly and he died the day after admission. Neither IgG nor IgM antibodies against dengue were found, but PCR on dengue virus RNA was positive. Over past decades there has been a strong increase in the number of dengue virus infections in travellers returning from Southeast Asia, Central and South America, the Caribbean and Africa. Whilst in general a primary dengue virus infection does not result in severe disease, this case illustrates the potentially fatal consequences of dengue in travellers.

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