Tahir Mohammad, Gupta Ekta, Salmani Sueba, Padma M V, Singh M B, Dar L, Broor S, Sharma S K
Department of Medicine, All India Institute of Medical Sciences, New Delhi 110029, India.
J Clin Virol. 2006 Sep;37(1):65-7. doi: 10.1016/j.jcv.2006.05.006. Epub 2006 Jun 21.
Neurological manifestations of dengue fever are rarely reported during acute illness and clinical presentation commonly observed is of acute encephalitis or one of the post-infectious immune mediated manifestations. We describe a case of dengue fever having mild encephalopathy and papilledema at presentation.
Twenty-year-old female presented with fever, headache and vomiting. On examination she did not have classical signs of dengue fever and was found to have bilateral papilledema on fundus examination. Detailed work-up did not reveal any other cause of papilledema. Diagnosis of dengue fever was established by blood IgM antibody test on day 7 of illness. Retrospective analysis of CSF (drawn on day 5 of illness) by RT-PCR assay showed a characteristic band of dengue-3 virus. Papilledema was transient and subsided following symptomatic treatment. The patient recovered from acute illness and follow-up was unremarkable.
Especially in dengue endemic areas, in the patients having acute febrile illness with subtle signs and symptoms suggestive of CNS involvement, dengue virus infection should also be ruled out early in the clinical course.
登革热的神经系统表现很少在急性发病期被报道，常见的临床表现为急性脑炎或感染后免疫介导的表现之一。我们描述了一例登革热患者，其在发病时伴有轻度脑病和视乳头水肿。
一名20岁女性，出现发热、头痛和呕吐症状。检查时，她没有登革热的典型体征，眼底检查发现双侧视乳头水肿。详细检查未发现视乳头水肿的其他病因。在发病第7天通过血液IgM抗体检测确诊为登革热。对发病第5天采集的脑脊液进行逆转录聚合酶链反应（RT-PCR）检测的回顾性分析显示了登革热3型病毒的特征条带。视乳头水肿是短暂的，经对症治疗后消退。患者从急性疾病中康复，随访无异常。
特别是在登革热流行地区，对于患有急性发热性疾病且有提示中枢神经系统受累的细微体征和症状的患者，在临床过程早期也应排除登革热病毒感染。
