Dengue encephalitis as a sole presentation of dengue fever in a child, is it a separate clinical entity?

Authors

  • Radhapyari Lourembam Department of Paediatrics, Regional Institute of Medical Sciences, Imphal, Manipur, India
  • Rahees V. K. Department of Paediatrics, Regional Institute of Medical Sciences, Imphal, Manipur, India
  • Shyamsunder Singh C. Department of Paediatrics, Regional Institute of Medical Sciences, Imphal, Manipur, India

DOI:

https://doi.org/10.18203/2349-3291.ijcp20233614

Keywords:

Dengue encephalitis, Neurotropism, Dengue fever

Abstract

Dengue fever is one of the common viral infections in tropical areas, especially in India. Though classically non-neurotropic in nature, recent literature has documented dengue viral neurotropism, suggesting possible elements of direct encephalitis. However, limited reports are available in paediatric age groups. Here we report a case of dengue encephalitis in a 3-year 6 months-old male child from Imphal, Manipur, India who presented with a history of fever, altered sensorium, and seizures. The anti-dengue immunoglobulin M antibodies were positive in serum. Cerebrospinal fluid analysis showed lymphocytic pleocytosis with elevated proteins and normal glucose. Neuroimaging was unremarkable. We also ruled out other causes of encephalitis by appropriate investigations. Our case did not have the typical salient features of dengue fever and recovered fully with the supportive treatment on time. The case highlights that dengue encephalitis may present even in the absence of neuroimaging findings and classical clinical signs of dengue fever. Hence, dengue encephalitis should be suspected in a child with fever with altered sensorium and seizures, especially in areas where dengue fever is endemic.

 

References

Dengue: guidelines for diagnosis, treatment, prevention and control. Available at: https://www. who.int. Accessed on 20 June 2023.

Varathraj A. Encephalitis in the clinical spectrum of dengue infection. Neurol India. 2010;58:585-91.

Murthy JM. Neurological complications of dengue infection. Neurol India. 2010;58:581-4

Solomon T, Dung NM, Vaughn DW, Kneen R, Thao LT, Raengsakulrach B, et al. Neurological manifestations of dengue infection. Lancet. 2000;3: 355.

Sahu R, Verma R, Jain A, Garg RK, Singh MK, Malhotra HS, et al. Neurologic complications in dengue virus infection: a prospective cohort study. Neurology. 2014;83:1601-9.

Araújo FM, Brilhante RS, Cavalcanti LP, Rocha MF, Cordeiro RA, Perdigão AC, et al. Detection of the dengue non-structural 1 antigen in cerebral spinal fluid samples using a commercially available enzyme-linked immunosorbent assay. J Virol Methods. 2011;177:128-31.

Bhoi SK, Naik S, Kumar S, Phadke RV, Kalita J, Misra UK. Cranial imaging findings in dengue virus infection. J Neurol Sci. 2014;342:36-41.

Puccioni-Sohler M, Orsini M, Soares CN. Dengue: a new challenge for neurology. Neurol Int. 2012;4:e15.

Dudipala SC, Mandapuram P, Chinma LK. Dengue encephalitis in children “Not an uncommon entity but is rarely thought of”: A case report. J Pediatr Neurosci. 2020;15:301-3.

Downloads

Published

2023-11-27

Issue

Section

Case Reports