title: [A Case of Dengue Fever and Subsequent Long-lasting Depression Accompanied by Alopecia in a Japanese Traveler Returning from Bali, Indonesia].
abstract: Recovery from dengue fever is generally rapid and uneventful. However, recuperation is often prolonged and may be accompanied by noticeable depression. We present herein on a traveler to Indonesia who developed long-lasting depression after the classic symptoms of dengue fever such as fever, arthralgia, and macropapular rash had resolved. A previously healthy 42-year old japanese woman presented to the Travel Clinic of Seirei Yokohama Hospital with complaints of 4 days of fever, joint aches, bone pain, and a macropapular rash on her torso. She had returned from Bali 5 days previously. During her 1-week stay, one day was spent in rural, mountainous areas where she was exposed to several mosquito bites. The 1st serum sample collected 4 days after the disease onset gave positive result in the rapid dengue IgM antibody test and the rapid dengue NS1 antigen immunechromatographic test. The DENV-1 genome was detected with RT-PCR. Her 13-year old son, who had accompanied her, was also diagnosed as having dengue fever and he recovered without event. The Above-mentioned symptoms resolved within one week. However, the patient suffered from prolonged depression. She also noticed loss of hair 3 months after the disease onset Administration of a Serotonin-Noradrenalin Reuptake Inhibitor and a minor tranquillizer required to allow her requied to lead a normal life. Although she gradually felt better, it took approximately 2 years until she had recovered completely without taking any antidepressant and minor tranquillizer. It is a well-known fact in endemic countries that dengue fever could have an significant impact on the patients' mental well-being. However, it appears that physicians in non-endemic countries are not fully aware of the prolonged depression, which can occur subsequent to the acute illness. Follow-up consultations of returing travelers who have recoverd from dengu fever should be arranged to monitor their mental and emotional states closely.
authors.forename: Akihiro
authors.initials: A
authors.lastname: Hitani
authors.forename: Waka
authors.initials: W
authors.lastname: Yamaya
authors.forename: Masako
authors.initials: M
authors.lastname: To
authors.forename: Ichino
authors.initials: I
authors.lastname: Kano
authors.forename: Natsue
authors.initials: N
authors.lastname: Honda-Hosono
authors.forename: Tomohiko
authors.initials: T
authors.lastname: Takasaki
authors.forename: Kosuke
authors.initials: K
authors.lastname: Haruki
mesh_terms: D000328:Adult; D000505:Alopecia / Q000209:etiology*; D044466:Asian People; D003715:Dengue / Q000150:complications*; D003863:Depression / Q000209:etiology*; D005260:Female; D006801:Humans; D007214:Indonesia; D014195:Travel