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We read this publication on "Risk of stroke in patients with dengue fever: a population-based cohort study" with a great interest [1]. Li et al. concluded that "In this population-based study, the presence of dengue was associated with an increased risk of stroke. The effect of dengue on stroke may be acute rather than chronic [1]." We would like to share ideas and experience from our country in Indochina where there is an extremely high prevalence of dengue. The neurological complication due to dengue is a possible but stroke is extremely uncommon [2]. in the present study, it is unlikely to control the other confounding factors that might result in the occurrence of stroke. If there is an actual increased risk, there should be any possible pathomechanism. In fact, the main problem in dengue is the hemostatic disorder and the only possible mechanism is hemorrhage. Nevertheless, the hemorrhagic stroke is rare and a good clinical supportive care due acute dengue infection is usually sufficient to prevent dengue complication [3].
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References
1. Li HM, Huang YK, Su YC, Kao CH. Risk of stroke in patients with dengue fever: a population-based cohort study. CMAJ. 2018 Mar 12;190(10):E285-E290.
2. Wiwanitkit S, Wiwanitkit V. Neurological complications in dengue infection. Arq Neuropsiquiatr. 2014 Mar;72(3):259.
3.Wiwanitkit V. Intracranial Hemorrhage in Dengue: Where Is It? Asian J Neurosurg. 2017 Oct-Dec;12(4):804.