Dengue haemorrhagic fever in a child presenting as encephalitis on day one of fever

Abeywardana, S; Peiris, P J P; Gunasekara, A C M; Sinhabahu, V. P.

doi:10.4038/cmj.v57i4.5091

Cited by 2 publications

(2 citation statements)

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“…Studies have reported an association between presence of lethargy, severe abdominal pain, and body cavity effusions at admission in patients with dengue that evolved to severity, not always accompanied by hemorrhage [ 16 , 17 , 25 , 26 , 29 , 33 , 35 – 37 ]. Lethargy is not only a sign of hypovolemic shock, but can also indicate encephalopathy, an atypical and severe presentation of dengue in children [ 38 – 40 ].…”

Section: Discussionmentioning

confidence: 99%

Use of Warning Signs for Dengue by Pediatric Health Care Staff in Brazil

et al. 2016

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ObjectiveThe aim of this study was to describe the use of dengue warning signs by pediatric healthcare staff in the Brazilian public health care system.MethodsCross-sectional study (2012) with physicians, nurses, and nurse technicians assisting children in five health care facilities. Participants reported the use and importance of dengue warning signs in pediatrics clinical practice through a structured questionnaire. Differences in the use of signs (chi-square test) and in the ranking assigned to each of them (Kruskal-Wallis) were assessed according to health care occupation and level of care (p<0.05).ResultsThe final sample comprised 474 participants (97%), mean age of 37 years (standard deviation = 10.3), mainly females (83.8%), physicians (40.1%) and from tertiary care (75.1%). The majority (91%) reported using warning signs for dengue in pediatrics clinical practice. The most widely used and highly valued signs were major hemorrhages (gastrointestinal, urinary), abdominal pain, and increase in hematocrit concurrent or not with rapid decrease in platelet count. Persistent vomiting as well as other signs of plasma leakage such as respiratory distress and lethargy/restlessness were not identified as having the same degree of importance, especially by nurse technicians and in primary or secondary care.DiscussionAlthough most health care staff reported using dengue warning signs, it would be useful to extend the training for identifying easily recognizable signs of plasma leakage that occur regardless of bleeding.

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Section: Discussionmentioning

confidence: 99%

Use of Warning Signs for Dengue by Pediatric Health Care Staff in Brazil

et al. 2016

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“…When dengue disease is enhanced by the antibody, it generates a profound neuroinflammatory response [36]. On day one of dengue infection, it can lead to the development of encephalitis [37,38]. A recent case report from Pakistan has also published an acute encephalopathy due to dengue infection [39].…”

Section: The Evidence For the Involvement Of Neuroinflammation In Den...mentioning

confidence: 99%

The Involvement of Neuroinflammation in Dengue Viral Disease: Importance of Innate and Adaptive Immunity

Niranjan

Muthukumaravel

Jambulingam

2019

Neuroimmunomodulation

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Neuroinflammation (inflammation in brain) has been known to play an important role in the development of dengue virus disease. Recently, studies from both clinical and experimental models suggest the involvement of neuroinflammation in dengue viral disease. Studies in clinical setup demonstrated that, microglial cells are actively involved in the patients having dengue virus infection, showing involvement of innate immune response in neuroinflammation. It was further proved that, clinical isolates of dengue-2 virus were able to initiate the pathologic response when injected in the mice brain. Natural killer cells were also found to play a crucial role to activate adaptive immune response. Notably, CXCL10/IFN-inducible protein 10 and CXCR3 are involved in dengue virus-mediated pathogenesis and play an important role in the development of dengue virus-mediated paralysis. In a latest report, it was seen that intracranial injection of dengue virus increases the CD8+ T-cell infiltration in brain, showing an important mechanism of neuroinflammation during the dengue virus infection. A similar study has described that, when DENV-3 is injected into the mice, it enhances the infiltration of CD8+ and CD4+ T cells as well as neutrophils. Cells immune-reactive against NS3 antigen were found throughout the brain. In conclusion, we focus on the various molecular mechanisms which contribute to the basic understanding about the role of neuroinflammation in dengue fever. These mechanisms will help in better understanding dengue pathophysiology and thus help in the development of possible therapeutics.

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Dengue haemorrhagic fever in a child presenting as encephalitis on day one of fever

Cited by 2 publications

References 3 publications

Use of Warning Signs for Dengue by Pediatric Health Care Staff in Brazil

Use of Warning Signs for Dengue by Pediatric Health Care Staff in Brazil

The Involvement of Neuroinflammation in Dengue Viral Disease: Importance of Innate and Adaptive Immunity

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