Department of Neurology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India.
J Neurol Sci. 2011 Jan 15;300(1-2):14-8. doi: 10.1016/j.jns.2010.10.022. Epub 2010 Nov 16.
Acute dengue myositis is characterized by fever and myalgia (with or without muscle weakness).
The 7 cases of acute dengue myositis were retrospectively evaluated in the present study. Dengue myositis was diagnosed on the basis of a clinical picture consistent with the infection, elevated creatine phosphokinase, normal CSF, positive serum IgM for dengue virus, and the exclusion of other causes.
The mean age of patients was 19.4 (range 3-40) years. Majority (5) of the patients were male. In our series 3 of the cases suffered from fulminant myositis. They were characterized by generalized weaknesses which included the respiratory muscles. All the 3 patients had markedly elevated creatine phosphokinase levels (ranging from 16,590 to 117,200 IU/L). Two patients suffering from fulminant myositis required mechanical ventilation. However, they succumbed to their illnesses. The third patient showed signs of improvement. One case had paraparesis and an elevated creatine phosphokinase level. However, a spontaneous complete recovery was observed. The remaining 3 cases had quadriparesis with trunk and neck weaknesses, sparing of respiratory muscles, creatine phosphokinase levels up to 3000 U/L. However, a complete recovery was observed in these patients within 4 weeks.
To conclude, early respiratory involvement, high creatine phosphokinase values, and severe myalgia suggest a severe form of dengue myositis.
急性登革热肌炎的特征是发热和肌痛（伴或不伴肌肉无力）。
本研究回顾性评估了 7 例急性登革热肌炎患者。登革热肌炎的诊断依据是与感染一致的临床表现、肌酸磷酸激酶升高、正常脑脊液、登革病毒血清 IgM 阳性以及排除其他原因。
患者的平均年龄为 19.4 岁（范围 3-40 岁）。大多数（5 例）患者为男性。在我们的系列中，有 3 例患有暴发性肌炎。其特征是全身无力，包括呼吸肌。所有 3 例患者的肌酸磷酸激酶水平均显著升高（范围为 16,590 至 117,200 IU/L）。2 例患有暴发性肌炎的患者需要机械通气。然而，他们都去世了。第 3 例患者表现出好转迹象。1 例患者出现截瘫和肌酸磷酸激酶水平升高。然而，观察到自发性完全恢复。其余 3 例患者出现四肢无力，伴有躯干和颈部无力，但呼吸肌不受累，肌酸磷酸激酶水平高达 3000 U/L。然而，这些患者在 4 周内完全恢复。
总之，早期呼吸受累、高肌酸磷酸激酶值和严重肌痛提示存在严重的登革热肌炎。
