Expanded dengue syndrome complicated by fulminant liver failure and prolonged intrahepatic cholestasis

We report a case of expanded dengue syndrome in a 38-year old man who developed fulminant liver failure and prolonged intrahepatic cholestasis. Initially presenting with fever, weakness, and jaundice, he was diagnosed with dengue by positive NS1 antigen, polymerase chain reaction, and Immunoglobulin M tests. Despite supportive care, the patient progressed to severe hepatic encephalopathy and coagulopathy ensued. Management included N-acetylcysteine infusion, thromboelastography-guided transfusions and sedation with propofol. Persistent cholestatic jaundice was managed with ursodeoxycholic acid. The patient's condition gradually improved, highlighting the importance of tailored interventions for severe dengue liver complications.