Dengue encephalitis in French Guiana

Hommel, Didier; Talarmin, Antoine; Denis, Vincent; Reynes, Jean-Marc; Drouet, Marie-Thérèse; Sarthou, Jean-Louis; Hulin, A.

doi:10.1016/s0923-2516(98)80005-8

Cited by 49 publications

(26 citation statements)

References 10 publications

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“…In conclusion, serotypes 2 and 3 have primarily been reported to cause neurologic symptoms, and these patients may experience both primary and secondary infections. 2,3,5,8,17 In our study group, there was an equal distribution of primary and secondary infections. Four patients with primary infection were infants in whom maternal antibodies may have caused immune enhancement.…”

Section: Discussionmentioning

confidence: 61%

“…In addition, a number of patients with DHF and concurrent neurologic symptoms have been described, mainly as case reports or as part of minor series of patients with unusual manifestations of DHF. [3][4][5][7][8][9][10]13,14 In previous reports of neurologic involvement in dengue infections, the observed encephalopathy was thought to be due to prolonged DHF with fluid extravasation, cerebral edema, hyponatremia, and liver failure, renal failure, or both, as opposed to encephalitis defined by a localized invasion of the CNS. Recent reports, however, have demonstrated a possible direct neurotropic effect of dengue virus.…”

Section: Discussionmentioning

confidence: 99%

“…In recent years, we and others have occasionally received DHF patients with symptoms of encephalopathy. [1][2][3][4][5][6][7][8][9][10] The pathophysiology of the neurologic symptoms in the reported cases have been attributed to cerebral edema, anoxia, hemorrhage, hyponatremia, hepatic failure, microcapillary hemorrhage, and release of toxic substances. Animal and clinical studies have recently suggested a neurotropic potential of dengue virus leading to encephalitis in some cases.…”

Section: Introductionmentioning

confidence: 99%

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Prospective case-control study of encephalopathy in children with dengue hemorrhagic fever.

Cam¹,

Fonsmark²,

Hue³

et al. 2001

Am J Trop Med Hyg

216

171

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Abstract. We present a prospective case-control study of 27 serologically confirmed dengue hemorrhagic fever (DHF) patients with severe central nervous system symptoms. Dengue associated encephalopathy accounted for 0.5% of 5,400 patients admitted with DHF. The mortality rate among children with encephalopathy was 22%, with the survivors experiencing a complete recovery. Liver enzymes and bilirubin were significantly elevated in the study group. In analysis of the cerebrospinal fluid (CSF), reverse transcriptase-polymerase chain reaction revealed dengue-3-specific RNA in one evaluated case. Dengue-specific immunoglobulin M was detected in CSF in 14 of 22 assessable patients, indicating a localized infection. Magnetic resonance imaging scans showed cerebral edema in the majority of patients, although encephalitis-like changes were less common. There was an equal distribution of primary and secondary infections. On the basis of previous reports and of the findings of our study, DHF probably encompasses an expanding clinical spectrum that infrequently involves encephalitis due to a direct neurotropic effect of dengue virus.

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Section: Discussionmentioning

confidence: 61%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Prospective case-control study of encephalopathy in children with dengue hemorrhagic fever.

Cam¹,

Fonsmark²,

Hue³

et al. 2001

Am J Trop Med Hyg

216

171

View full text Add to dashboard Cite

show abstract

“…In acute phase of dengue infection, dengue shock syndrome (DSS), brain edema, cerebral anoxia, metabolic acidosis, electrolyte disturbances, vasculitis, liver and kidney failure can cause encephalopathy 20 .…”

Section: Denv and Metabolic Disturbancementioning

confidence: 99%

Neurological complications in dengue infection: a review for clinical practice

Puccioni-Sohler

Rosadas

Cabral‐Castro

2013

Arq. Neuro-Psiquiatr.

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The dengue virus belongs to the Flaviviridae family. There are four closely related, but antigenically different virus serotypes: DENV1 to DENV4. An infection caused by one of them can cause dengue fever and, rarely, most severe form of the disease. The infection provides life-long protective immunity to the same subtype, but no immunity against the other three serotypes. Moreover, previous infection with a different subtype increases the chances of developing dengue hemorrhagic fever. This is due to a phenomenon called antibody dependent enhancement (ADE). In ADE, the heterotypic non-neutralizing antibodies form complexes with dengue virus, which infect mononuclear phagocytes with enhanced efficiency. Consequently, a higher number of host cells are infected, improving viral replication, worsening the clinical signs. Thus, this may also contribute to the development of neurological and other complications 1 . The neurological manifestations are mainly associated with DENV-2 and DENV-3. These serotypes were found in cases of encephalitis, meningitis and myelitis 2,3 . DENV-4 was also detected in brain cells by immunohistochemistry and in cerebrospinal fluid (CSF) of a patient with encephalitis 4 . The present article highlights some important points that should be addressed when evaluating a possible case of neurological complication of dengue virus infection. Conflict of interest:There is no conflict of interest. ABStrACtDengue is an important global public health problem. The World Health Organization estimates that 2/5 of entire world population are in risk of dengue infection. Almost 50 millions cases occur annually, with at least 20 thousand deaths. The etiological agent of this acute febrile disease is a single-strand positive-sense RNA virus of Flavivirus genus. It is an arboviral disease transmitted by Aedes sp. mosquitoes (Aedes aegypti and A. albopictus). Most infected individuals present asymptomatic infection, but some may develop clinical signs. Therefore, a wide spectrum of illness can be observed, ranging from unapparent, mild disease, called dengue fever, to a severe and occasionally fatal dengue hemorrhagic fever/dengue shock syndrome. Currently, neurological manifestations related to dengue infections are increasingly been observed and appears as a challenge for medical practice. In this study the neurological complications of dengue infection will be reviewed, focusing a better understanding of the disease for the clinical practice.Keywords: dengue, nervous system, diagnosis. rESUMO A dengue é um importante problema de saúde pública. A Organização Mundial de Saúde estima que 2/5 da população mundial encontra-se em risco de desenvolver a infecção. Cerca de 50 milhões de casos ocorrem anualmente, com ao menos 20 mil mortes. O agente etiológico desta doença febril aguda é um vírus RNA, do gênero Flavivirus. Este arbovírus é transmitido pelo mosquito Aedes sp. A maioria dos indivíduos infectados apresenta infecção assintomática, porém alguns desenvolvem sintomas clínicos. Estes manifestações podem...

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“…Dengue became a very common disease in Brazil, with more than 4 million of cases registered between 1986 and 2006 [40]. The involvement of CNS in dengue infection has been reported, but its frequency has not been established yet [41][42][43][44][45][46][47][48][49]. As recently reported by Domingues et al, the most frequent manifestation of CNS involvement in acute dengue virus infection is mental confusion as part of diffuse encephalitis, usually with good prognosis [50].…”

Section: Arthropod-borne Viral Encephalitismentioning

confidence: 99%