# Locally Acquired Dengue Virus Infection in a Non-endemic Area

## TL;DR

A case of locally acquired dengue fever is reported in a non-endemic area, highlighting the need for increased clinical awareness.

## Contribution

This case report highlights the possibility of local dengue transmission in non-endemic regions.

## Key findings

- A patient presented with dengue fever symptoms without recent travel to endemic regions.
- The diagnosis was challenging due to the patient's lack of exposure to dengue-endemic areas.
- The case underscores the importance of considering dengue in febrile illness differential diagnoses.

## Abstract

Dengue virus (DENV) infection occurs through the transmission of the virus via mosquito vectors that are largely endemic to subtropical or tropical regions in the world. Patients from non-endemic areas typically report recent travel history and sudden onset of high fever, accompanied by severe headache, retro-orbital pain, and nausea. We present a case of a patient with a locally acquired dengue fever infection in a non-endemic area in Southern California. An extensive medical evaluation was performed by multiple physicians in various healthcare settings, ultimately leading to this diagnosis. Though our patient's presenting constellation of symptoms was consistent with dengue fever, his lack of exposure to an area known to be endemic for DENV made this a surprising and extraordinarily challenging diagnosis. This case report demonstrates the importance of maintaining a high index of clinical suspicion for acute DENV infection in those presenting with an acute febrile illness and findings concordant with this diagnosis.