Dengue infection with central nervous system manifestations

A prospective observational study was conducted over a seven years period to determine the clinical and laboratory findings of dengue patients with central nervous system manifestations. Thirty serologically confirmed dengue infected patients with central nervous system manifestations were seen at the Department of Pediatrics, Faculty of Medicine, Chulalongkorn University, Bangkok and at Songkhla Hospital, Songkhla, Thailand. The age ranged between 3 months and 14 years with a mean age of 6.2 years. Seventeen were boys and thirteen were girls. The central nervous system manifestations included alteration of consciousness 76.7%, seizures 63.3%, pyramidal tract signs 36.7%, meningeal signs 30% and headache 26.7%. Eleven patients had primary while 19 had secondary dengue infection. Cerebrospinal fluid examination showed lymphocytic pleocytosis in 6 out of 28 patients while presence of anti-dengue IgM antibodies was detected in 2 out of 19 specimens of cerebrospinal fluid tested. Two patients died, autopsy was done on one patient and examination of the brain was compatible with viral encephalitis.