Neurological manifestations of Kyasanur Forest disease: a retrospective cohort study from South India

Abstract

Background Kyasanur Forest disease (KFD) is a viral zoonotic disease where patients present with febrile illness and haemorrhagic manifestations in the first phase. In a small fraction of patients, the fever may be biphasic. This study aimed to describe the neurological manifestations of patients with KFD in the first and second phases of the illness. Methods This is a retrospective cohort study of 297 patients admitted with a molecular diagnosis of KFD from December 2018 to December 2020. The case records of these patients were reviewed for evidence of neurological involvement. Results A total of 34 (11.5%) patients in the first phase and 16 (36.4%) patients in the second phase had neurological involvement. Altered sensorium, seizures and focal infarcts were common in the first phase, while cerebellar signs and leptomeningeal enhancement were common in the second phase. Conclusions Neurological involvement is seen in both phases of KFD. While in the first phase it is a result of possible encephalitis/encephalopathy, the second phase involvement is possibly due to postinfectious cerebellitis or meningitis.

Development of a clinical scoring system to make a presumptive diagnosis of Kyasanur Forest Disease: a case-control study from South India

“…CNS involvement was also significantly common in KFD compared to other febrile illnesses. This is similar to previous studies that showed CNS involvement in the form of encephalitis or encephalopathy to be a common finding in patients with the first phase of KFD [11,12]. Conjunc- Notes: KFD-Kyasanur Forest Disease, Lymphadenopathy (Cervical lymph nodes palpable on clinical examination), Hepatosplenomegaly (enlarged liver or spleen on clinical examination), LRT involvement-Lower respiratory tract involvement (presence of dyspnoea, requirement of supplemental oxygen or infiltrate on Chest X-ray), myocarditis (clinical suspicion along with elevated troponin), CNS involvement-Central nervous system involvement (altered sensorium or neck signs), Raised HCT-Raised Haematocrit (more than 40), Leucocytosis (Total leucocyte count more than 11,000/ cu.mm), Leukopenia (Total leucocyte count of less than 4,000/ cu.…”

A Case Series on the Spectrum of Complications Observed in Kyasanur Forest Disease

“…Adhikari Prabha et al reported altered sensorium in 45% and seizures in 24% [12]. Gupta et al [16] in a study of 297 patients, reported altered sensorium and seizures as the clinical symptoms and focal infarcts as the major radiological findings in the first phase. In the second phase, the common symptoms were cerebellar signs and vision abnormalities.…”