Abstract
IntroductionPost-infectious cerebellitis is an acute form of inflammatory encephalitis mainly limited to the cerebellum. It is commonly found in children, especially after viral infections such as Epstein-Barr virus. Post-infectious cerebellitis presents with acute onset dysarthria and ataxia. To the best of our knowledge, this is the first case report of post-infectious cerebellitis in a patient with both dengue and Epstein-Barr viral infection confirmed on serology.Case presentationA 43-year-old Sri Lankan Sinhala man presented with an acute febrile illness associated with thrombocytopenia. While being managed as uncomplicated dengue fever, our patient developed dysarthria, ataxia and cerebellar signs. Our patient's infectious disease screen was positive for both dengue and Epstein-Barr specific immunoglobulin M. A cerebrospinal fluid analysis was suggestive of viral meningoencephalitis while cerebrospinal fluid serology was positive for dengue immunoglobulin G. T2-weighted magnetic resonance images were consistent with post-viral cerebellitis. The patient was given full supportive care and he made an uneventful complete recovery.ConclusionThere have been no previously reported cases of post-infectious cerebellitis associated with both Epstein-Barr and dengue viral infections confirmed by serology. Our patient's clinical features and findings on the imaging studies were consistent with post-viral cerebellitis. This report highlights the need to screen for other possible more common etiologies of a particular presentation before coming to a specific diagnosis based on initial findings. Uncomplicated cases of cerebellitis can be successfully managed with appropriate supportive measures with good prognosis, as in this case.
Highlights
Post-infectious cerebellitis is an acute form of inflammatory encephalitis mainly limited to the cerebellum
There have been no previously reported cases of post-infectious cerebellitis associated with both Epstein-Barr and dengue viral infections confirmed by serology
Uncomplicated cases of cerebellitis can be successfully managed with appropriate supportive measures with good prognosis, as in this case
Summary
To the best of our knowledge, there have been no previously reported cases of cerebellitis associated with dengue viral infection. Despite having clinical and laboratory evidence suggestive of dengue, other possible etiological agents for post-infectious cerebellitis were sought as this was an unusual presentation of dengue. Besides describing interesting MRI features of postinfectious cerebellitis, this case illustrates the importance of having an open mind when an unusual presentation of a known disease is investigated. It improves our understanding of clinical and laboratory features of post-infectious cerebellitis and provides insight into unusual clinical presentations in general. Consent Written informed consent was obtained from the patient for publication of this case report and any accompanying images. A copy of the written consent is available for review by the Editor-in-Chief of this journal
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