He catches dengue fever and begins to have an erection that lasts 18 hours: the ordeal of a teenager who could not imagine such a symptom

Un jeune homme a attrapé la dengue et développe des symptômes étonnants. (illustration) Alexander Gray/Unsplash

Une équipe de médecins du Burkina Faso rapporte dans la revue Urology Case Reports le cas d’un jeune homme de 17 ans, traité à Ouagadougou en service de néphrologie pour une dengue sévère.

One of its symptoms, directly linked to the virus, particularly caught their attention: an incomplete erection lasting 18 hours, non-painful and persistent.

A case "Out of the ordinary", according to doctors at the Ouagadougou University Hospital in Burkina Faso. These professionals describe in the journal Urology Case Reports of March 2024, the case of a 17-year-old adolescent. The young man suffered from severe dengue fever, an infectious disease caused by tiger mosquitoes.

"We report an exceptional case of arterial priapism occurring spontaneously in a 17-year-old adolescent, recently admitted to the nephrology department for acute tubular necrosis following severe dengue& ;quot;,explains the doctors at the hospital center.

Arterial priapism ? This erectile dysfunction is manifested by an involuntary penile erection lasting more than four hours and without any sexual stimulation. It is most often due to trauma responsible for dysregulation of the arterial flow of the corpora cavernosa.

"An incomplete, non-painful and persistent erection"

The 17-year-old student had no medical history. He had been hospitalized for 5 days in nephrology. "For approximately 18 hours, he presented an incomplete, non-painful and persistent erection, occurring spontaneously without any sexual stimulation, without any notion of trauma or any triggering factor, motivating the healthcare team to seek urological advice& ;quot;, specify the doctors.

A bag of ice was placed on the young man's penis. After 48 hours, complete detumescence, without after-effects, was observed. The patient was seen at 3 and 6 months by a urologist for monitoring; the corpora cavernosa were supple and erections normal.

Vascular leaks responsible for priapism

While arterial priapism is usually found after trauma or surgery of the penis, how can we explain it in this adolescent ?

Dengue is a hemorrhagic fever characterized by increased vascular permeability, which leads to vascular leakage. "These vascular leaks and hemorrhagic manifestations when they occur in the cavernous arteries can short-circuit the helicine arteries (the arteries which allow erection, editor's note) passing directly from a cavernous artery to the blood of the corpora cavernosa. This will lead to unregulated arterial blood flow in the corpora cavernosa, causing high-flow priapism, detail the authors of the article.

"This case provides us with a unique opportunity to deepen our understanding of the complex interactions between dengue and priapism, thereby pushing the limits of our medical expertise . We note that severe dengue fever can be the cause of both arterial and venous priapism, concludes the doctors.

From 2000 to 2019, according to the WHO, the number of dengue cases increased tenfold, from 500,000 to 5.2 million. 2019 saw an unprecedented spike, with cases reported in 129 countries. In 2022, in France, the number of cases of autochthonous dengue had seen a clear increase, 66 autochthonous cases and 378 imported cases.

The upward trend is expected to continue in 2023 while the tiger mosquito, responsible for the transmission of the dengue virus, is established in a large majority of French departments.