Dengue encephalitis: A case highlighting neurological complications and diagnostic challenges

Area of Science:

• Neurology
• Infectious Diseases
• Virology

Background:

• Dengue virus infection can lead to severe neurological complications, including encephalitis.
• Dengue encephalitis is a significant public health concern, particularly in endemic regions.

Observation:

• A case report details a female in her 20s with dengue encephalitis, exhibiting fever, headache, vomiting, and altered sensorium.
• Initial investigations revealed leukocytosis, thrombocytopenia, and hepatic enzyme abnormalities.
• Cerebrospinal fluid analysis confirmed Dengue virus serotype 2 (DENV-2) via PCR, and dengue non-structural protein 1 (NS1) antigen testing was positive.

Findings:

• Brain imaging demonstrated bilateral thalamic edema, progressing to hemorrhage and diffuse cerebral edema.
• The patient's condition deteriorated rapidly despite intensive supportive care.
• The case resulted in the patient's death on day 7 of illness.

Implications:

• This case underscores the diagnostic challenges of dengue encephalitis, especially when serological markers are not immediately definitive.
• Highlights the critical need for prompt recognition, aggressive supportive management, and advanced diagnostic modalities for severe dengue cases.
• Emphasizes the importance of considering dengue encephalitis in the differential diagnosis of unexplained encephalopathy in endemic areas.