When dengue meets immunosuppression: a case of severe disease in a renal transplant recipient.

This report describes a 72-year-old renal transplant recipient who presented to a Midwestern hospital with severe dengue fever after recent travel to Mexico. The patient's clinical course was complicated by shock, mucosal bleeding, prolonged pancytopenia, and concurrent extended-spectrum beta-lactamase Eschirichia coli bacteremia. Management of this patient included selective platelet transfusions, antibiotics, and reduction of immunosuppressive therapy to support hematologic recovery. This case highlights the complexities of treating severe dengue infections in immunocompromised patients, the challenges of coinfections, and the careful use of platelet transfusions.