Involvement of the central nervous system in dengue fever and its outcome.
AbstractThe involvement of the central nervous system in dengue-affected children, the spectrum of neurological manifestations and the presence of dengue-specific IgM antibodies in the cerebrospinal fluid (CSF) was studied. A prospective study was conducted of all consecutive serum-positive dengue patients (n=100) admitted to the hospitals attached to the Jagadguru Jayadeva Murugharajendra Medical College, Davangere, Karnataka state, India, from January 2009 to September 2010. Children who presented with neurological symptoms were grouped separately and CSF was cultured and routine tests for cells, sugar, protein and chlorides were done. Further CSF was subjected for dengue IgM estimation. The study showed that the neurological incidence was 40%. Seizures were present in 70% of cases and altered sensorium was present in 80% of cases. Papilloedema and cranial nerve palsy were observed in 30% of cases and meningeal signs were present in 80% of cases. CSF protein was high in 80% of cases and pleocytosis was present in 80% of cases. CSF IgM was positive in 35% of cases. The mortality observed in this study was 4%. It was concluded that dengue fever encompasses an expanding clinical spectrum and is not just restricted to the WHO-specified criteria for making a diagnosis of dengue fever other than dengue haemorrhagic fever and dengue shock syndrome. It frequently causes encephalitis probably due to a direct neurotropic effect of dengue virus.
Kulkarni, ML & Kumar, Saurabh. (2011). Involvement of the central nervous system in dengue fever and its outcome.. WHO Regional Office for South-East Asia.. http://www.who.int/iris/handle/10665/171013