Dengue Fever Complicated by Watermelon Stomach: A Case Report

Abstract

This report describes a 35-year-old male with dengue fever who developed acute upper gastrointestinal bleeding due to watermelon stomach–like lesions, an uncommon and rarely reported manifestation in dengue. The patient presented with fever and was diagnosed with dengue via serology. On day three of illness, he developed melena, tachypnea, hypoxemia, and pleural effusion. Urgent upper gastrointestinal endoscopy revealed characteristic linear erythematous stripes in the gastric antrum consistent with watermelon stomach. He was managed conservatively with supplemental oxygen, judicious fluid resuscitation, and pantoprazole infusion. His symptoms resolved within 72 hours. Repeat endoscopy two weeks after discharge demonstrated complete resolution of the antral mucosal lesions. This case highlights a transient watermelon stomach phenotype associated with dengue fever, likely secondary to acute endothelial injury and thrombocytopenia, rather than true gastric antral vascular ectasia (GAVE), and underscores the effectiveness of supportive management.