Dengue fever in Lebanon: First confirmed case since 1945 and review from the region.

Lebanon yearly witnesses a high flux of expatriates and workers from Dengue virus (DENV) endemic regions. Multiple cases of Dengue fever have been documented at the American University of Beirut Medical Center (AUBMC) in travellers to endemic regions. Given the presence of the Aedes aegypti mosquito in Lebanon, introduction of DENV to the country is highly likely. We report a case of DENV infection in Lebanon diagnosed in April 2012 in a patient with no prior travel history. The patient presented with fever (39°C) and lower urinary tract symptoms and was initially diagnosed with culture negative prostatitis. He was started on empiric antibiotics but continued to have severe headache, diffuse myalgias, bone pain, and fatigue. He later developed a faint rash with leukopenia and thrombocytopenia. Extensive work-up was unrevealing. DENV IgM and IgG were positive suggesting acute infection. This is the first reported case since 1945 from Lebanon in a patient with no prior travel history.