Cerebrospinal fluid analysis in dengue in a tertiary care center
DOI:
https://doi.org/10.18203/2320-6012.ijrms20202046Keywords:
Cerebrospinal fluid, Dengue, Headache, Meningeal signs, Meningoencephalitis, Neurological manifestationsAbstract
Background: Clinical profile of dengue is variable including neurological manifestations like encephalopathy and encephalitis which are not being reported very frequently. This study is an attempt to know the cerebrospinal fluid (CSF) finding in dengue infected patients with neurological manifestations in a tertiary care hospital Eastern Odisha.
Methods: Study conducted from August 2018 to July 2019 comprising of 100 dengue seropositive (NS1/IgM/IgG) patients of age >15 years in IMS and SUM Hospital.
Results: A total of 100 (66 boys and 34 girls) hospitalised patients (Age >15 years) diagnosed as dengue were enrolled in our study. Total 20 cases Cerebrospinal fluid analysis has been done in which we found 70% (13 cases) unclassified viral meningitis, 15% (3 cases) bacterial meningitis, 5% (1 case) tuberculous meningitis, 5% (1 case) herpes encephalitis and 5% (1 case) Japanese encephalitis. Neurological manifestations in all dengue sero positive cases (100) found 30% headache, 18% altered sensorium, 5% seizure, 4% syncope, 3% papilloedema, 1% CN palsy and 11% meningeal signs.
Conclusions: Dengue meningoencephalitis must be thought of in differentials of all febrile encephalopathy. This study brings out the incidence of different meningoencephalitis on the bases of CSF analysis including coinfections. So in dengue patients with neurological manifestation should do CSF analysisfor better outcome of a disease.
References
Jairaj S, Sridhar D, Reddy MP. Clinical, laboratory and radiological profile of dengue among pediatric patients admitted in tertiary care hospital. Int J Comm Medi Pub Health. 2018 Jun;5(6):2237-42.
Srikant D. A Study on the Clinicopathological Profile and Outcome of a Dengue Epidemic in Western Odisha. Int J Med Sci Innov Res. 2017;2(4):13-20.
Martelli CM, Siqueira JB, Junior MP, Zara AL, Oliveira CS, Braga C, et al. Economic impact of dengue: multicenter study across four Brazilian regions. PLoS Neglec Trop Dis. 2015 Sep;9(9).
Gupta N, Srivastava S, Jain A, Chaturvedi U. Dengue in India. Ind J Medi Res. 2012 Mar 1;136(3):373-90.
Kadam DB, Salvi S, Chandanwale A. Expanded Dengue. J Assoc Physici Ind. 2016 Jul;64(7):59-63.
Li GH, Ning ZJ, Liu YM, Li XH. Neurological manifestations of dengue infection. Frontiers Cellul Infect Microbiol. 2017 Oct 25;7:449.
Calderón-Peláez MA, Velandia-Romero ML, Bastidas-Legarda LY, Beltran EO, Camacho-O SJ, Castellanos JE. Dengue virus infection of blood-brain barrier cells: consequences of severe disease. Frontiers Microbiol. 2019;10:1435.
Kulkarni ML, Saurabh K, Kalvehalli S. Central Nervous System Involvement and its Outcome in Dengue Fever. RGUHS J Medi Scie. 2012 Apr 1;2(2):74-7.
Dhar SK, Samant S, Mishra S, Tripathy D, Shah RD, Prasad RC. Spectrum of Ophthalmic Manifestations of Dengue: Our Experience in a Tertiary Care Centre. JMSCR. 2019;7(4):1120-8.
Wangdi K, Kasturiaratchi K, Nery SV, Lau CL, Gray DJ, Clements AC. Diversity of infectious aetiologies of acute undifferentiated febrile illnesses in south and Southeast Asia: a systematic review. BMC Infect Dis. 2019 Dec;19(1):577.
Kulkarni ML, Kumar S. Involvement of the central nervous system in dengue fever and its outcome. Deng Bullet. 2011 Dec;35:52-8.
