Ref Number = PITIKA-ASPR0146
Mas Wishnuwardhana, Thomas Harry Adoe, Rizky Chintia,Dina Siti Daliyanti, Tri Yanti, Charles Silalahi, Siti Rahmah, Adi
OBJECTIVE:  to study expanded dengue syndrome a specialy encelopathy dengue.
Patient was admitted to the ER of regional hospital bekasi on May 19th2019 with seizures, and unconsciousness. Patient had fever 3 days before the admission to the hospital. Fever appeared all of a sudden and were felt constantly high. The next day, patient experienced vomiting as much as 4 times a day. The patient's mother said that since the patient vomited, the patient experienced a decrease in appetite and tend to vomit every time he was fed. According to the patient's mother, there is a garbage dump near their house that stored a lot of used plastics and also the weather was rainy these days. The mother never cleaned the bath tubs and never closed the buckets that filled with water. There was a dengue fever outbreak around their housing area. No abnormalities on urination and defecation, the patient did not experience nosebleeds nor gum bleeding. GCS obtained was 12, spontaneous bleeding (-). Complete blood test showed in the ER revealed leukocytosis of 15.6 thousand/uL, hemoglobin level of 13.8 g/dL, hematocrit of 42%, platelets count of 150 thousand/uL and at the time of follow-up, complete blood count showed leukocytes of 8.9 thousand/uL, hemoglobin of 10.1 g/dL, hematocrit of 30.8%, platelets of 57 thousand/uL and a hemoconcentration is revealed.On RLD chest X-ray examination shown dextra pleural effusion with an index of pleural effusion: 40% and the CT scan revealed a cerebral edema and an absence of cerebral bleeding. Management of this patient including Ranitidine, Ondancentron, Amino Acid and Dexamethasone have been administered, and a periodic laboratory on DHF series are examined. The patient has GCS of 15 when the patient went home, there were no respiratory distress.

CONCLUSION: to understanding management of dengue encelopathy.
Keywords: dengue encephalopathy, expanded dengue syndrome, seizure, pleural effusion, cerebral edema
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