{
  "abstract": "Background: Varicella-zoster virus (VZV) infection and dengue virus infection are common viral illnesses in tropical regions. However, concurrent infections are rarely reported and may present significant diagnostic challenges because of overlapping clinical manifestations, including fever, rash, and hematologic abnormalities.\n\nCase presentation: We report a laboratory-confirmed co-infection with VZV and dengue virus in a previously healthy 17-year-old female patient from Quezon City, Philippines. She initially presented with a 3-day history of fever and a generalized pruritic vesicular rash and was treated for varicella with oral acyclovir. Despite antiviral therapy, persistent high-grade fever, epigastric abdominal pain, leukopenia (2.8 × 10⁹/l), and thrombocytopenia (85 × 10⁹/l) prompted further investigation on the fourth day of illness. Diagnostic testing confirmed acute dengue infection by positive nonstructural protein 1 antigen and dengue immunoglobulin M test results, while VZV polymerase chain reaction testing of vesicular fluid confirmed varicella. The patient received supportive dengue management alongside continued acyclovir therapy. Clinical symptoms improved, with resolution of fever by the sixth day of illness, normalization of hematologic parameters, and progressive crusting of lesions. She was discharged without complications.\n\nConclusions: This case highlights the importance of considering dengue co-infection in patients with apparent varicella who develop persistent fever, abdominal pain, leukopenia, or thrombocytopenia in dengue-endemic settings. Early laboratory confirmation is essential to distinguish overlapping clinical features, guide appropriate management, and prevent missed or delayed diagnoses.",
  "abstract_shown": true,
  "affiliations": [
    "Pediatric Infectious Disease and Tropical Medicine Department, San Lazaro Hospital, Manila, Philippines",
    "School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan",
    "San Lazaro Hospital-Nagasaki University Collaborative Research Office, San Lazaro Hospital, Manila, Philippines",
    "Department of Clinical Research, London School of Hygiene and Tropical Medicine, London, UK",
    "Department of Clinical Infectious Diseases, Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan"
  ],
  "article_type": "case report",
  "arxiv": null,
  "author_total": 4,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "John Kelvin S. Gabot"
    },
    {
      "affs": [
        0
      ],
      "name": "Ruth Faye R. Sengson"
    },
    {
      "affs": [
        1,
        2,
        3,
        4
      ],
      "name": "Chris Smith"
    },
    {
      "affs": [
        1,
        2,
        4
      ],
      "name": "Su Myat Han"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/09dtng6fjwat2.bib",
  "cited_by": 0,
  "doi": "10.1016/j.ijregi.2026.101026",
  "fulltext_url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC13698059/",
  "id": "09dtng6fjwat2",
  "issns": [
    "2772-7076"
  ],
  "landing_url": "https://doi.org/10.1016/j.ijregi.2026.101026",
  "language": "en",
  "licence": "CC-BY-NC-ND-4.0",
  "licence_label": "CC BY-NC-ND 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by-nc-nd/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "Case Report"
    ],
    [
      "openalex",
      "2739|Mosquito-borne diseases and control"
    ]
  ],
  "openalex": "W7214313243",
  "pdf_url": "https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13698059/pdf/?tool=EBI",
  "pmcid": "PMC13698059",
  "pmid": "42936464",
  "published": "2026-09-25",
  "publisher": "Elsevier",
  "ris": "https://research.draconitic.com/paper/09dtng6fjwat2.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:19:00Z",
      "native_id": "PMC13698059",
      "source": "pmc",
      "url": "https://doi.org/10.1016/j.ijregi.2026.101026"
    },
    {
      "first_seen": "2026-10-30T12:21:50Z",
      "native_id": "PMC:PMC13698059",
      "source": "europepmc",
      "url": "https://europepmc.org/article/PMC/PMC13698059"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2739|Mosquito-borne diseases and control",
      "subfield": "epidemiology-public-health"
    }
  ],
  "title": "Concurrent varicella and dengue infection in an adolescent female: diagnostic and clinical challenges in an endemic setting",
  "title_text": "Concurrent varicella and dengue infection in an adolescent female: diagnostic and clinical challenges in an endemic setting",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:34:59Z",
  "url": "https://research.draconitic.com/paper/09dtng6fjwat2",
  "venue": "IJID Regions",
  "versions": []
}