Department of Radiology, Dr Balabhai Nanavati Hospital, Mumbai 400056, India.
Pediatric Intensive Care Unit, Department of Pediatrics and Neonatology, Dr Balabhai Nanavati Hospital, Mumbai 400056, India.
J Trop Pediatr. 2020 Jun 1;66(3):322-326. doi: 10.1093/tropej/fmz060.
Among neurological complications associated with dengue, posterior reversible encephalopathy syndrome (PRES) has not been reported in pediatric population. We report a 10-year-old girl with severe dengue who developed PRES. The patient presented with hemorrhagic shock that required fluid resuscitation and inotropic support. She developed seizures with encephalopathy 2 days after recovering from the shock. Cerebrospinal fluid (CSF) examination was negative for dengue (no white blood cells in CSF with negative polymerase chain reaction for dengue). Her clinical features and magnetic resonance imaging (MRI) findings showed typical changes associated with posterior encephalopathy that reverted after resolution of hypertension. Repeat MRI after a month was normal. PRES should be considered as a possible differential diagnoses of dengue associated encephalopathy, especially in cases with normal CSF examination and characteristic MRI changes.
在与登革热相关的神经并发症中，儿童中并未报告出现后部可逆性脑病综合征（PRES）。我们报告了一例 10 岁患有重症登革热的女孩，她出现了 PRES。患者出现失血性休克，需要液体复苏和正性肌力支持。她在休克恢复后 2 天出现癫痫发作和脑病。脑脊液（CSF）检查未发现登革热（CSF 中无白细胞，聚合酶链反应检测登革热为阴性）。她的临床特征和磁共振成像（MRI）结果显示与后部脑病相关的典型变化，在高血压得到控制后恢复正常。一个月后重复 MRI 正常。PRES 应被视为登革热相关脑病的可能鉴别诊断，尤其是在 CSF 检查正常且 MRI 特征性改变的情况下。
