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Chronic Dengue Virus Encephalitis: A Case Study and Metagenomic Analysis.
Gabriela Abrahao Allioni1, Gabriel Samir Martins de Souza1, Julia Haddad Labello1
1Department of Neurology, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Brazil.
Neurology(R) Neuroimmunology & Neuroinflammation
|April 11, 2025
Summary
This case study identifies Dengue virus type 1 (DENV-1) RNA in brain tissue, suggesting it as a rare cause of chronic encephalitis and progressive dementia. Metagenomic sequencing was key to this diagnosis.
Area of Science:
- Neuroscience
- Virology
- Genomics
Background:
- Dengue virus (DENV) infection is known to cause acute encephalitis.
- Chronic encephalitis presenting as progressive dementia is an uncommon manifestation of DENV infection.
Purpose of the Study:
- To report a rare case of chronic encephalitis with rapidly progressive dementia.
- To investigate the potential role of DENV in a challenging encephalitis case using advanced molecular techniques.
Main Methods:
- Brain tissue metagenomic next-generation sequencing (mNGS) was employed for pathogen identification.
- Comprehensive neuropathological examination and molecular diagnostics were performed.
- Clinical data, neuroimaging (MRI), and cerebrospinal fluid (CSF) analysis were systematically evaluated.
Main Results:
- A 20-year-old male presented with severe cognitive decline, including dementia, apraxia, and apathy.
- Neuroimaging showed white matter abnormalities and atrophy; CSF revealed mild pleocytosis and oligoclonal bands.
- Metagenomic analysis of brain biopsy identified Dengue virus type 1 (DENV-1) genotype V, with sequences linked to Brazil.
Conclusions:
- Metagenomic sequencing successfully detected DENV-1 RNA in brain tissue, implicating it as a potential cause of chronic encephalitis.
- This case underscores the utility of mNGS in diagnosing rare neurological infections with atypical presentations.
- Further research is warranted to understand the pathogenesis of chronic DENV encephalitis.
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