Central nervous system involvement in dengue: A tertiary care centre study

Saluja, Manoj; Swami, Yogesh Kumar; Chittora, Saurabh; Vimlani, Hemant

doi:10.1016/j.cmrp.2019.01.004

Cited by 1 publication

(3 citation statements)

References 17 publications

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“…Dengue encephalitis has an incidence of 5.4% to 6.2% in endemic countries and a mortality of 30–52% [ 3 , 5 ]. Early recognition is crucial to minimize the complications of dengue encephalitis.…”

Section: Discussionmentioning

confidence: 99%

“…The increased ROS can disrupt the blood-brain barrier, contributing to cerebral edema and CNS infections [ 12 ]. In severe dengue, neurological complications of dengue infection were previously attributed to the pathophysiology of severe dengue infection (ie, prolonged plasma leakage and hemorrhage causing hepatic encephalopathy, cerebral edema, and intracranial hemorrhage) [ 3 ]. We postulate that in dengue encephalitis, the elevated procalcitonin may further disrupt the blood-brain barrier and aggravate cerebral edema.…”

Section: Discussionmentioning

confidence: 99%

“…Even more rarely, the virus can infiltrate the central nervous system (CNS) and cause dengue encephalitis. The most common neurological symptoms in dengue encephalitis and encephalopathy are altered sensorium (93.8–100%), headache (63.3%), and seizure (53.3%) [ 3 ]. To distinguish dengue encephalitis from encephalopathy, the virus must be isolated in the CNS via serology, polymerase chain reaction, culture, or biopsy [ 4 ].…”

Section: Introductionmentioning

confidence: 99%

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A Rare Case of Dengue Encephalitis with Raised Procalcitonin

Nadarajan

Toh

2021

Am J Case Rep

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Patient: Male, 65-year-old Final Diagnosis: Dengue encephalitis Symptoms: AMS Medication:— Clinical Procedure: — Specialty: Infectious Diseases Objective: Rare co-existance of disease or pathology Background: Dengue virus is a common arbovirus with uncertain neurotropism. Dengue encephalitis is a rare but fatal manifestation of severe dengue. Diagnosis requires high clinical suspicion. It should be routinely considered in patients with encephalopathy, especially in countries where dengue virus is endemic. Unlike other forms of severe dengue, the typical warning signs and biochemical derangements are not reliable markers for dengue encephalitis. Alternative biochemical markers of dengue encephalitis are needed. Case Report: We present a case of dengue encephalitis with distinctly raised procalcitonin (13.2 μg/L), in the absence of the typical warning signs and biochemical derangements of severe dengue. The patient was a 65-year-old man with fever and sudden loss of consciousness in the absence of other localizing signs/symptoms. Inflammatory markers were raised, with findings of leptomeningeal enhancement on brain computed tomography suggestive of meningoencephalitis. Septic workup was unremarkable (normal renal and liver functions, negative blood and urine cultures). The typical neurotropic microorganisms were not detected in the cerebrospinal fluid. On day 4 of admission, the patient reported abdominal pain and hematuria with a new onset of bicytopenia. Subsequent investigations for dengue infection were positive for serum dengue NS1 antigen and dengue RNA (type 2 strain) in cerebrospinal fluid, confirming the diagnosis of dengue encephalitis. The patient was managed supportively and experienced full clinical recovery. Conclusions: Dengue encephalitis is a rare condition with nonspecific biochemical and imaging abnormalities. We demonstrated that a raised procalcitonin level can occur in the setting of dengue encephalitis. In endemic countries, this finding may prompt further investigations for dengue encephalitis in patients with meningoencephalitis.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%