Dalugama Chamara, Shelton John, Ekanayake Mahendra, Gawarammana Indika Bandara
Department of Medicine, University of Peradeniya, Galaha Road, Peradeniya, Sri Lanka.
University Medical Unit, Teaching Hospital, Peradeniya, Sri Lanka.
J Med Case Rep. 2018 May 15;12(1):137. doi: 10.1186/s13256-018-1626-y.
Dengue is an arboviral infection classically presenting with fever, arthralgia, headache, and rashes. It is hyperendemic in Sri Lanka and has a major impact on health. Neurological complications of dengue fever are rare but have been reported in the literature.
A 60-year-old Sri Lankan man presented with a history of fever, arthralgia, and generalized malaise of 2 days duration. A diagnosis of dengue was confirmed with leukopenia, thrombocytopenia, and positive NS1 antigen done on day 2 without evidence of hemoconcentration. On admission, our patient had weakness of the bilateral lower limbs, which progressed in an ascending pattern involving both upper limbs and neck muscles, requiring assisted ventilation. Electromyography confirmed a demyelinating polyneuropathy and cerebrospinal fluid showed albumincytological dissociation. He was treated with intravenous immunoglobulins and made an uneventful recovery. Subsequently, his immunoglobulin M test result for dengue virus was positive.
Guillain-Barré syndrome is a rare but possible neurological sequel following dengue fever. In regions where dengue is hyperendemic, screening for dengue illness may be important in patients presenting with acute flaccid paralysis.
登革热是一种虫媒病毒感染，典型症状为发热、关节痛、头痛和皮疹。在斯里兰卡，登革热是高度地方性流行疾病，对健康有重大影响。登革热的神经系统并发症虽罕见，但文献中已有报道。
一名60岁的斯里兰卡男子，有持续2天的发热、关节痛和全身不适病史。第2天进行的白细胞减少、血小板减少和NS1抗原阳性检查确诊为登革热，且无血液浓缩迹象。入院时，我们的患者双侧下肢无力，并呈上升趋势发展至累及双上肢和颈部肌肉，需要辅助通气。肌电图证实为脱髓鞘性多发性神经病，脑脊液显示蛋白细胞分离。他接受了静脉注射免疫球蛋白治疗，恢复顺利。随后，他的登革热病毒免疫球蛋白M检测结果呈阳性。
吉兰 - 巴雷综合征是登革热后罕见但可能出现的神经系统后遗症。在登革热高度地方性流行的地区，对出现急性弛缓性麻痹的患者进行登革热疾病筛查可能很重要。
