Acute disseminated encephalomyelitis associated with dengue infection: A case report with literature review

Gupta, Mukesh Kumar; Nayak, Ranu; Khwaja, Geeta Anjum; Chowdhury, Debashish

doi:10.1016/j.jns.2013.08.029

Cited by 32 publications

(28 citation statements)

References 8 publications

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“…There was no significant difference between cases with bad outcomes or complete recovery in the treatment used. Unlike a previous literature review which suggested that steroids are promising in the treatment of ADEM during its active phase [61]. …”

Section: Discussionmentioning

confidence: 88%

“…The neurological complications of dengue infection have been considered to be due to systemic complications of dengue and not related to its neurotropic nature [48, 61–65]. After the demonstration of neural tropism of dengue virus, the neurological manifestations of dengue infection are categorized as (1) related to direct neurotropic effects of the virus (myelitis, meningitis, myositis, rhabdomyolysis, and encephalitis), (2) related to systemic or metabolic complications of dengue (encephalopathy, stroke) and (3) post-infectious immune-mediated complications (GBS, transverse myelitis, ADEM).…”

Section: Discussionmentioning

confidence: 99%

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Post-dengue acute disseminated encephalomyelitis: A case report and meta-analysis

Kamel

Nam²,

Han

et al. 2017

PLoS Negl Trop Dis

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BackgroundDengue is one of the most common infectious diseases. The aim of this study was to systematically review acute disseminated encephalomyelitis (ADEM) and to represent a new case.Methodology/Principal findingsWe searched for articles in nine databases for case reports, series or previous reviews reporting ADEM cases in human. We used Fisher’s exact and Mann-Whitney U tests. Classification trees were used to find the predictors of the disease outcomes. We combined findings using fixed- and random-effects models. A 13-year-old girl was admitted to the hospital due to fever. She has a urinary retention. The neurological examinations revealed that she became lethargic and quadriplegic. She had upper limbs weakness and lower limbs complete paraplegia. Her status gradually improved after the treatment. She was nearly intact with the proximal part of her legs had a mild weakness in discharge. The prevalence of ADEM among dengue patients was 0.4% [95% confidence intervals (95% CI) 0.1–2.5%], all neurological disorders among dengue was 2.6% [95% CI 1.8–3.8%], and ADEM among neurological disorders was 6.8% [95% CI 3.4–13%]. The most frequent manifestation of ADEM was altered sensorium/consciousness (58%), seizures and urination problems (35%), vision problems (31%), slurred speech (23%), walk problems (15%) then ataxia (12%). There was a significant difference between cases having complete recovery or bad outcomes in the onset day of neurological manifestations being earlier and in temperature being higher in cases having bad outcomes (p-value < 0.05). This was confirmed by classification trees which included these two variables.Conclusions/SignificanceThe prevalence of ADEM among dengue and other dengue-related neurological disorders is not too rare. The high fever of ADEM cases at admission and earlier onset day of neurological manifestations are associated with the bad outcomes.

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Section: Discussionmentioning

confidence: 88%

Section: Discussionmentioning

confidence: 99%

Post-dengue acute disseminated encephalomyelitis: A case report and meta-analysis

Kamel

Nam²,

Han

et al. 2017

PLoS Negl Trop Dis

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“…Prior to 2013, dengue virus serotype 3 (DENV-3) had not been identified in the Pacific island nations for almost 20 years. Meanwhile neurological and autoimmune complications have been reported during outbreaks of different flaviviruses but are not frequent for dengue, and more important for viruses with neurological tropism such as West Nile [53][54][55][56][57][58]. One case of GuillainBarré syndrome following DEN 4 infection has been reported in French Polynesia in the literature [59].…”

Section: The Clustering In Time Of Gbs Cases Is Considered Unusual Asmentioning

confidence: 99%

Potential for Zika virus transmission through blood transfusion demonstrated during an outbreak in French Polynesia, November 2013 to February 2014

et al. 2014

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Since October 2013, French Polynesia has experienced the largest documented outbreak of Zika virus (ZIKAV) infection. To prevent transmission of ZIKAV by blood transfusion, specific nucleic acid testing of blood donors was implemented. From November 2013 to February 2014: 42 (3%) of 1,505 blood donors, although asymptomatic at the time of blood donation, were found positive for ZIKAV by PCR. Our results serve to alert blood safety authorities about the risk of post-transfusion Zika fever.

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“…37,[55][56][57][58][59][60][61] Neurological symptoms include seizures, altered sensorium, and focal neurological deficits; they may occur following the hyperpyrexic phase of dengue. 57,58 Mild pleocytosis and moderate rise in protein concentration can be detected in the CSF. Brain MRI may show white matter lesions on T2-weighted images in the centrum semiovale, corona radiate, corpus callosum, and thalamus.…”

Section: Acute Disseminated Encephalomyelitismentioning

confidence: 99%

Neurological manifestations of dengue viral infection

Carod-Artal

2014

RRTM

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Dengue is the most common mosquito-borne viral infection worldwide. There is increased evidence for dengue virus neurotropism, and neurological manifestations could make part of the clinical picture of dengue virus infection in at least 0.5%-7.4% of symptomatic cases. Neurological complications have been classified into dengue virus encephalopathy, dengue virus encephalitis, immune-mediated syndromes (acute disseminated encephalomyelitis, myelitis, Guillain-Barré syndrome, neuritis brachialis, acute cerebellitis, and others), neuromuscular complications (hypokalemic paralysis, transient benign muscle dysfunction and myositis), and dengue-associated stroke. Common neuro-ophthalmic complications are maculopathy and retinal vasculopathy. Pathogenic mechanisms include systemic complications and metabolic disturbances resulting in encephalopathy, direct effect of the virus provoking encephalitis, and postinfectious immune mechanisms causing immune-mediated syndromes. Dengue viruses should be considered as a cause of neurological disorders in endemic regions. Standardized case definitions for specific neurological complications are still needed.

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Acute disseminated encephalomyelitis associated with dengue infection: A case report with literature review

Cited by 32 publications

References 8 publications

Post-dengue acute disseminated encephalomyelitis: A case report and meta-analysis

Post-dengue acute disseminated encephalomyelitis: A case report and meta-analysis

Potential for Zika virus transmission through blood transfusion demonstrated during an outbreak in French Polynesia, November 2013 to February 2014

Neurological manifestations of dengue viral infection

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