Acharya Sourya, Shukla Samarth, Mahajan S N, Diwan S K
Department of Medicine, J.N Medical College, DMIMS University, Sawangi (Meghe), Wardha - 442 004, Maharashtra, India.
Ann Indian Acad Neurol. 2010 Jul;13(3):221-2. doi: 10.4103/0972-2327.70882.
Dengue is an acute mosquito-borne infection caused by dengue viruses from the genus flavivirus. Neurologic complications have been attributed chiefly to metabolic alterations and to focal and sometimes massive intracranial haemorrhages, but anecdotal cases and limited case series have indicated the possibility of viral CNS and skeletal muscle invasion causing encephalitis and myositis. We present a case of a 40-year-old male who presented with severe dengue myositis resulting in quadriparesis, respiratory failure and acute renal failure with red urine. His elevated serum creatine kinase (CK), serum and urine myoglobin levels justified rhabdomyolysis as the cause of acute renal failure. A muscle biopsy revealed inflammatory myositis. He required ventilator support for respiratory failure and was treated conservatively. This case highlights the severe and persistent muscle involvement in dengue which is a rarity.
登革热是一种由黄病毒属登革病毒引起的急性蚊媒感染。神经并发症主要归因于代谢改变以及局灶性甚至有时是大量颅内出血，但一些个案和有限的病例系列表明，病毒侵袭中枢神经系统和骨骼肌导致脑炎和肌炎是有可能的。我们报告一例40岁男性患者，其因严重登革热肌炎导致四肢瘫痪、呼吸衰竭和伴有血尿的急性肾衰竭。他血清肌酸激酶（CK）、血清和尿肌红蛋白水平升高，证明横纹肌溶解是急性肾衰竭的病因。肌肉活检显示为炎性肌炎。他因呼吸衰竭需要呼吸机支持，并接受了保守治疗。该病例突出了登革热中严重且持续的肌肉受累情况，这种情况较为罕见。
