Abstract
Dengue is a common tropical disease occurring in Sri Lanka. Neurological manifestations due to dengue are very rare but can be caused by serotypes 2 and 3. Here we present a patient with meningoencephalitis occurring as a manifestation of dengue haemorrhagic fever (DHF) in a young boy who presented with fever, constitutional symptoms and a seizure. Diagnosis was confirmed by NS1 positivity and the presence of dengue specific IgM in the CSF with characteristic electroencephalographic findings. He was treated according to the dengue local national guidelines and had complete recovery without residual neurological deficits.
Highlights
Dengue (DEN) is a mosquito born flavivirus infection with a clinical spectrum which ranges from asymptomatic infection to haemorrhagic fever and severe shock
We present a patient with meningoencephalitis occurring as a manifestation of dengue haemorrhagic fever (DHF) in a young boy who presented with fever, constitutional symptoms and a seizure
His cerebrospinal fluid (CSF) culture showed no evidence of bacterial growth. His CSF for dengue IgM antibody was positive on day 4 with a positive serum dengue specific IgM and IgG antibody on day 10. He was managed according to the national guidelines for dengue haemorrhagic fever published by the Ministry of Health, Sri Lanka.[4]
Summary
Dengue (DEN) is a mosquito born flavivirus infection with a clinical spectrum which ranges from asymptomatic infection to haemorrhagic fever and severe shock. Dengue is well known to be neurotropic in animal models as well as humans. Though human CNS infection is rare, considerable amount of evidence is increasingly reported to prove neural involvement of the DEN virus during the recent past.[1,2] Neurological manifestations include dengue encephalopathy, direct neuropathic effects (dengue encephalitis, meningitis), immunemediated syndromes (acute disseminated encephalomyelitis, myelitis, Guillain–Barré syndrome, neuritis brachialis ), neuromuscular complications (hypokalaemic paralysis, transient benign muscle dysfunction, myositis), dengue-associated stroke and neuroophthalmic complications (maculopathy, retinal vasculopathy).[3] dengue encephalitis is a rare entity.[1] Here, we present a case of dengue meningoencephalitis in a young man who presented with generalized seizures on the second day of a febrile illness
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