Skip directly to site content Skip directly to page options Skip directly to A-Z link Skip directly to A-Z link Skip directly to A-Z link
Volume 18, Number 4—April 2012
Dispatch

Dengue in Patients with Central Nervous System Manifestations, Brazil

Fernanda AraújoComments to Author , Rita Nogueira, Maurício de Sousa Araújo, Anne Perdigão, Luciano Cavalcanti, Raimunda Brilhante, Marcos Rocha, Dina Feitosa Vilar, Suzana Silveira Holanda, Deborah de Melo Braga, and José Sidrim
Author affiliations: State Health Secretariat of Ceará, Fortaleza, Ceará, Brazil (F.M.C. Araújo, A.C.B. Perdigão, D.C.L. Feitosa Vilar, S.G. Silveira Holanda and D.N. de Melo Braga); Oswaldo Cruz Institute, Rio de Janeiro, Rio de Janeiro, Brazil (R.M.R. Nogueira); Dr. José Frota Institute, Fortaleza (M. de Sousa Araújo); Federal University of Ceará, Fortaleza (L.P.G., Cavalcanti, F.M. de Carvalho Araújo, J.J. da Costa Sidrim, R.S.N. Brilhante, M.F.G. Rocha); State University of Ceará, Fortaleza (A.C.B. Perdigão); College Christus, Fortaleza (L.P.G. Cavalcanti)

Main Article

Table 1

Clinical features and virologic findings for 8 patients with meningitis/meningoencephalitis and confirmed cases of dengue, Brazil, 2005–2008*

Patient no. Age, y/sex Initial symptoms and signs Progress and outcome RT-PCR NS1Ag IgM IgG ND
1 45/M Fever, headache, sweating, thorax pain, seizure, coma, chronic hypertension. Cerebral edema and congestion; mononuclear cells in meninges; death after 6 d – + – – ME
2 32/F Fever, vomiting, neck stiffness, myalgia, abdominal pain, asthenia, somnolence, confusion Meningitis, sixth nerve palsy; death after 14 d DENV-3 + – – ME
3 1/M Fever, tremors, rigidity of limbs, otitis Intracranial hypertension, meningitis; death after 24 h – + + – M
4 6/F Fever, headache, malaise, vomiting, drowsiness, neck stiffness CSF: clear, 133 cells/mm3, 42% lymphocytes, 2% monocytes, 53% neutrophils, 3% eosinophils; protein 58 g/L, glucose 54 g/L; recovery after 9 d – – + + M
5 58/M Fever, headache, severe malaise, vomiting, lowering of consciousness, delirium CSF: 300 cells/mm3; lymphocytes, 87%, monocytes 5%, neutrophils 4%, protein 112 g/L, glucose 59 g/L; serum: AST 127 U/L, ALT 74 U/L; CT scan: expansible lesion measuring 4 × 2 x 2.3 cm; referred for surgical treatment – – + + Brain tumor; M
6 5/F Fever, headache, vomiting, neck stiffness CSF: 490 cells/mm3, 2% monocytes, 5% lymphocytes, 93% neutrophils, protein 45 g/L, glucose 110 g/L; recovery after 8 d – – + M
7 15/M Fever, headache, arthralgia, severe malaise, dry cough, dyspnea, epigastric pain IHC result positive for dengue.
CSF: clear; cerebrum and cerebellum with marked edema and vasocongestion of meninges and nerve tissue; death after 5 d – + – – ME
8 24/M Fever, headache, vomiting, and neck stiffness CSF: 426 cells/mm3; protein 136 g/L, glucose 55 g/L; recovery – – + + M

*RT-PCR, reverse transcription PCR; NS1Ag, nonstructural protein 1 antigen; ND, neurologic diagnosis; –, negative; +, positive; ME, meningoencephalitis; DENV, dengue virus; M, meningitis; CSF, cerebrospinal fluid; AST, aspartate aminotransferase; ALT, alanine aminotransferase; CT, computed tomography; IHC, immunohistochemical test.

Main Article

Page created: March 15, 2012
Page updated: March 15, 2012
Page reviewed: March 15, 2012
The conclusions, findings, and opinions expressed by authors contributing to this journal do not necessarily reflect the official position of the U.S. Department of Health and Human Services, the Public Health Service, the Centers for Disease Control and Prevention, or the authors' affiliated institutions. Use of trade names is for identification only and does not imply endorsement by any of the groups named above.
file_external