Neurological Involvement in Dengue: An Autopsy Study

Abstract

ABSTRACT Dengue is a mosquito-borne disease that is a public health concern and outbreaks have increased in India. The virus produces fever, hemorrhagic fever, and shock syndrome. Dengue may cause encephalopathy. Few autopsies in individuals with neurological complaints have been documented. Our paper reports on an adult with dengue and neurological symptoms with postmortem findings. Thirty-six-year-old presented with a 2-day fever. He was febrile with a normal systemic exam. By evening, he was stuporous. His platelet count was moderately decreased to about 80,000/cumm. His serum and cerebrospinal fluid (CSF) were positive for dengue non-structural (NS) 1 antigen (Ag). He deteriorated and succumbed on day 4. An autopsy was performed to determine the cause of death. On examination, the brain was edematous with frontoparietal, internal capsule, and brain stem hemorrhages. Microscopy showed vascular congestion, edema, multiple hemorrhages, and liquefactive necrosis. In India, diagnostic testing is limited. This patient’s platelet count was not too low, but postmortem findings of brain hemorrhages highlight the necessity of recognizing its uncommon manifestations.