Background: Dengue is a mosquito-transmitted viral infection that causes symptoms such as fever, headaches, joint pain, nausea, vomiting, and retroorbital pain. In more severe instances, it can progress and cause liver involvement, ranging from mild transaminitis to acute liver failure. ^[1]

Case presentation: We present a case series of three Asian males who presented with similar symptoms of fever and body ache for few days. They were diagnosed with dengue virus based on lab results showing severe thrombocytopenia and a positive PCR test.

Upon admission, all the patients were vitally stable, alert, and oriented, though dehydrated. Their physical examination showed no major abnormalities except for dehydration. Initial lab results showed a severely low platelet count and elevated liver function tests (high AST, ALT), indicating liver dysfunction. Coagulation parameters and C-reactive protein were also elevated.

Management included IV fluids and symptomatic treatment. During hospital stay, patients deteriorated further with worsening liver function, leading to acute hepatic failure, treated with N-acetylcysteine.

Despite complications, their platelet count and liver functions gradually improved with supportive care, and all three patients were discharged in a stable condition.