CLINICAL PROFILE OF NEUROLOGICAL COMPLICATIONS OF DENGUE FEVER IN A TERTIARY CARE CENTER

Dr. L. Rajagopala Marthandam MD*, Dr. P. Renuga MD and Dr. Susan George

ABSTRACT

Introduction: Dengue fever is highly endemic in India especially in southern parts. In recent years, the virological characteristics of dengue viruses have been changing, resulting in widespread neurological complications. The neurological complication in dengue infection has been mainly hypothesized through three pathogenic mechanisms: like neurotropism leading to encephalitis, meningitis, myositis and myelitis, systemic complications and (3) post-infectious immune-mediated complications. Materials and Methodology: In this prospective study, we studied various neurological complications observed in patients admitted in a tertiary care center in south Tamil Nadu during the period from June 2017 to December 2017. Patients with neurological complications with positive serology (IgM antibody) for dengue infection were identified and investigations were done to elucidate the cause. Results: According to our study neurological complications showed a female predominance with maximum cases among age group 20-29 years. Encephalitis and encephalopathy were the most common neurological manifestations. Shock was the most common etiology leading to encephalopathy. Fever, headache, retro orbital pain, altered sensorium and myalgia were the predominant symptoms. Majority of the patients developing neurological complications showed leucopenia and had elevated liver enzymes .Vast majority had gall bladder wall edema on USG abdomen. Bilateral thalamic hypo density was the most common observation in CT Brain. Conclusion: Neurological complications of dengue infection are widespread and may involve almost all parts of the nervous system through various mechanisms. So dengue infection should be considered and properly investigated in patients presenting with various neurological disorders without obvious etiology, especially if preceded by a febrile illness compatible with dengue fever.

Keywords: Encephalitis, meningitis, myositis and myelitis.