Dengue infection causing acute Hypokalemic paralysis: A case series

Dengue fever is a mosquito-borne illness responsible for a spectrum of neurological disorders like encephalitis, myelitis, neuropathy, myopathy, and hypokalemia. From mild febrile illness to severe shock syndrome. During the last epidemic, we did see few patients of dengue fever presenting with an acute onset of paresis secondary to hypokalemia, which we are reporting here. The present study evaluates the association between hypokalemia and the acute onset of paraparesis and quadriparesis in dengue infection. A retrospective cross-sectional study was conducted to evaluate the association of dengue fever and acute onset hypokalemic paralysis. Data from four patients were evaluated. All were male patients, and the mean age was 37 years. Two (50%) patients had an acute onset of quadriparesis, and another 2 (50%) had acute paraparesis. The average/mean serum potassium level was 2.0 meq/dl. The other possible causes of weakness were excluded by relevant history and investigations in all patients. The patients recovered completely after supplementation with potassium. Dengue infection can present with acute pure motor reversible paraparesis and quadriparesis due to hypokalemia, besides other neurological causes. Clinicians should be aware of such an association and consider the clinical possibility in the differential diagnosis while evaluating acute quadriparesis or paraparesis in patients with dengue fever, especially in endemic areas.