Looking Beyond Thrombocytopenia for Bleeding in a Case of Dengue Fever: From Dengue to Hemophilia C

Dengue fever causes thrombocytopenia, which can present with bleeding manifestations. Bleeding can range from less severe conditions like petechiae, epistaxis, and menorrhagia, to life-threatening situations like gastrointestinal bleed or intracranial bleed. We present a case of a young boy in his early twenties, who was admitted with Dengue fever, presenting with malena and blood in vomitus. He was managed on the lines of severe dengue with bleeding. However, malena, with a concurrent drop in haemoglobin, persisted despite normalisation of the platelet count. He was evaluated further and was found to have coagulopathy with factor XI deficiency (Hemophilia C) and a bleeding gastroesophageal junction ulcer.