title: 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.
authors.affiliation: Senior Resident, DO, DNB, Guru Nanak Eye Centre, New Delhi, India dr.sparshi@gmail.com.
authors.forename: Sparshi
authors.initials: S
authors.lastname: Jain
authors.affiliation: Senior Specialist, MS, Swami Dayanand Hospital, New Delhi, India.
authors.forename: Anup
authors.initials: A
authors.lastname: Goswami
authors.affiliation: Medical Officer, MS, Swami Dayanand Hospital, New Delhi, India.
authors.forename: Nidhi
authors.initials: N
authors.lastname: Singh
authors.affiliation: Senior Resident, MS, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
authors.forename: Savleen
authors.initials: S
authors.lastname: Kaur
mesh_terms: D000293:Adolescent; D003715:Dengue; D004438:Ecchymosis / Q000209:etiology*; D005141:Eyelid Diseases / Q000209:etiology*; D005334:Fever / Q000209:etiology; D006801:Humans; D008297:Male; D019595:Severe Dengue / Q000150:complications / Q000175:diagnosis*; D014839:Vomiting / Q000209:etiology
keywords: Dengue haemorrhagic fever; eyelid ecchymosis; subconjunctival haemorrhage; thrombocytopenia