Mamdouh Kalakatawi H, Mroog Kalakatawi M, Hani Nasser H, Nabil Elrefae M
Department of Neurology, Alnoor Specialist Hospital, King Abdullah Medical City, Holy Makkah, Kingdom of Saudi Arabia.
J Glob Infect Dis. 2013 Oct;5(4):183-6. doi: 10.4103/0974-777X.122021.
Although dengue meningitis is a rare presentation of dengue infection, our aim is to focus on atypical presentation of dengue meningitis that may appear in dengue endemic area like the Makkah region. We report two cases of clinical meningitis with positive dengue virus (DENV) IgM in cerebrospinal fluid, followed for minimal 3 months for their prominent attacks of migraine like headache, phobia, and arrhythmia. With special consideration to attack time, type, severity, and respond to classical therapy, using regular ECG monitoring, visual analog pain score and neuropsychological assessments were done. Both cases showed resistant migraine like headaches to classic anti-migraine therapy except for strong NSAID and narcotics with tendency to have severe to extreme severe daily migraine like headache on early to late afternoon time, associated with non-fatal arrhythmias and extreme death phobia, that resolve slowly in a minimal 3 month period. In conclusion, dengue meningitis in the endemic area may present atypically.
虽然登革热脑膜炎是登革热感染的一种罕见表现，但我们的目的是关注登革热脑膜炎的非典型表现，这种表现可能出现在像麦加地区这样的登革热流行地区。我们报告了两例脑脊液中登革病毒（DENV）IgM呈阳性的临床脑膜炎病例，对其进行了至少3个月的随访，观察其显著的偏头痛样头痛、恐惧症和心律失常发作情况。特别考虑发作时间、类型、严重程度以及对经典治疗的反应，通过定期心电图监测、视觉模拟疼痛评分和神经心理学评估来进行观察。两例病例均对经典抗偏头痛治疗有抵抗性偏头痛样头痛，除了强效非甾体抗炎药和麻醉药品外，在午后早期至晚期有严重至极严重的每日偏头痛样头痛倾向，伴有非致命性心律失常和极度死亡恐惧症，在至少3个月的时间内缓慢缓解。总之，流行地区的登革热脑膜炎可能表现为非典型。
