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Related Experiment Videos

Dengue encephalitis: a true entity?

L C Lum1, S K Lam, Y S Choy

  • 1Department of Pediatrics, University Hospital, Kuala Lumpur, Malaysia.

The American Journal of Tropical Medicine and Hygiene
|March 1, 1996
PubMed
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Dengue encephalitis can directly infect the brain, challenging previous theories. This study confirms neurovirulence in dengue virus types 2 and 3, suggesting direct viral invasion.

Area of Science:

  • Virology
  • Neurology
  • Infectious Diseases

Background:

  • Central nervous system involvement in dengue fever was traditionally attributed to secondary complications like vasculitis and cerebral edema, termed dengue encephalopathy.
  • Direct viral invasion of the brain (encephalitis) was considered unlikely in dengue infections.

Observation:

  • Six pediatric cases presented with clinical encephalitis on the second or third day of illness.
  • Diagnosis was supported by cerebrospinal fluid (CSF) microscopy and electroencephalography (EEG) findings.
  • All cases confirmed dengue infection, with Dengue 3 virus isolated from four and Dengue 2 detected in one.

Findings:

  • Dengue virus directly identified in CSF and blood samples of affected children.
  • Evidence suggests early-onset encephalitis coincides with the viremic phase, indicating potential blood-brain barrier crossing.

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  • Dengue 2 and Dengue 3 viruses demonstrated neurovirulent properties.

    • Implications:

    • This research provides strong evidence for direct neuroinvasion by dengue viruses, causing encephalitis.
    • Findings challenge the established understanding of dengue's neurological manifestations.
    • Dengue viruses (serotypes 2 and 3) exhibit neurovirulence, similar to other Flaviviridae family members.