# Fulminant myocarditis associated with severe dengue in a young patient from the Peruvian Amazon: case report and literature review

## TL;DR

A young man in the Peruvian Amazon died from severe dengue-related heart inflammation, highlighting the need for early detection and monitoring.

## Contribution

This case report adds to the understanding of rare but fatal dengue complications in tropical regions.

## Key findings

- A 21-year-old male died from dengue-induced cardiogenic shock within three days of hospitalization.
- The case emphasizes the importance of early recognition of myocardial involvement in dengue patients.
- Timely cardiovascular monitoring is critical to reduce mortality from dengue myocarditis.

## Abstract

Dengue is an endemic viral infection of tropical regions that can present with clinical presentations ranging from mild forms to severe complications. Dengue-associated myocarditis, although uncommon, is a potentially fatal complication that should be suspected in febrile patients from endemic areas presenting with signs of cardiovascular dysfunction. We present the case of a 21-year-old male, resident in the Peruvian Amazon, who developed acute heart failure and refractory cardiogenic shock secondary to dengue myocarditis, with a fatal outcome on the third day of hospitalization. This case highlights the importance of early recognition of myocardial involvement and timely cardiovascular monitoring to reduce mortality associated with this infection.

El dengue es una infección viral endémica de regiones tropicales que puede presentarse con manifestaciones clínicas que van desde formas leves hasta complicaciones severas. La miocarditis asociada al dengue, aunque poco frecuente, constituye una complicación potencialmente fatal que debe sospecharse ante la presencia de signos de disfunción cardiovascular en pacientes febriles de zonas endémicas. Se presenta el caso de un varón de 21 años, residente en la Amazonía peruana, que desarrolló insuficiencia cardíaca aguda y shock cardiogénico refractario secundario a miocarditis por dengue, con desenlace fatal al tercer día de hospitalización. Este caso resalta la importancia del reconocimiento temprano de la afectación miocárdica y del monitoreo cardiovascular oportuno para reducir la mortalidad asociada a esta infección.