Background: Dengue fever is an arthropod-borne viral infection with a very high incidence
rate in Southeast Asia. Most patients present with self-limiting febrile illness, while some patients
may develop complications like acute kidney injury, acute liver failure, myocarditis or Guillain–
Barre syndrome. The coexistence of Dengue and MRSA (Methicillin-resistant Staphylococcus
aureus ) is rarely reported in the literature.
Case: A 28-year-old male is presented with high-grade fever, polyserositis and thrombocytopenia.
The patient was treated symptomatically for dengue infection. During the course of hospitalization,
patient developed neck swelling (thyroid abscess) and left forearm abscess. MRSA was isolated
from blood culture and pus, and successfully treated with iv antibiotics (Vancomycin).
Conclusion: High anticipation and vigilance are required to detect concurrent bacteremia in
dengue patients. Early recognition of warning signs with readily antibiotic therapy is important to
prevent mortality and morbidity in these patients. Our report also highlights the MRSA as a rare
cause of thyroid abscess, with only 5 cases reported in the literature so far.