Dual Infection with Dengue Virus Serotype 1 and 2 in a Patient in Western Mexico

On physical examination, the patient did not have severe clinical symptoms, but he presented with myalgia, exanthema, arthralgia, abdominal pain, headache, fatigue, and nausea. Interestingly, both alanine transaminase (ALT) and aspartate transaminase (AST) remained at normal levels during this simultaneous infection, despite it has observed that dengue infection is associated with accelerated progression of liver damage during the acute infection phase. [...]is the case of interleukin-2, which is associated with an increase in ALT and AST levels, and therefore its inhibition could not only participate in the downregulation of the liver enzymes but also regulate the synthesis and release of the tumor necrosis factor-α, producing a less severe clinical course in those patients.