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婴儿登革热脑炎继发脑积水:病例报告。

Hydrocephalus secondary to dengue encephalitis in an infant: case report.

机构信息

Department of Neurological Surgery, Children's Hospital, Goiânia, Brazil.

Department of Neurological Surgery, Hospital Estadual Alberto Rassi, Goiânia, Brazil.

出版信息

Childs Nerv Syst. 2021 Jul;37(7):2357-2361. doi: 10.1007/s00381-020-04876-0. Epub 2020 Sep 7.

Abstract

BACKGROUND

Dengue is the leading cause of mosquito-borne viral infection. It is responsible for high morbidity and mortality in children living in endemic areas. Nowadays, neurological complications are progressively referred to and include a broad spectrum of symptoms. It can be secondary to metabolic alterations, direct invasion by the virus, and enhanced autoimmune response.

CASE PRESENTATION

Here, we report a rare case of hydrocephalus secondary to dengue encephalitis. A 13-day-old boy was diagnosed with dengue. He evolved with seizures and impaired consciousness being diagnosed with encephalitis. After clinical treatment, he was discharged fully recovered. Three months later, he presented with signs and symptoms of intracranial hypertension. Brain MRI revealed hydrocephalus secondary to acquired aqueduct stenosis. The patient underwent an endoscopic third ventriculocisternostomy.

CONCLUSION

Dengue infection is a differential diagnosis for acute febrile neurological impairment in children from endemic areas. Follow-up should be offered after dengue encephalitis to detect possible late-onset complications, as hydrocephalus.

摘要

背景

登革热是由蚊子传播的病毒感染的主要原因。它在生活在流行地区的儿童中导致高发病率和死亡率。如今,神经并发症逐渐被提及,包括广泛的症状。它可能继发于代谢改变、病毒直接侵袭和增强的自身免疫反应。

病例介绍

在这里,我们报告了一例罕见的登革热脑炎继发脑积水病例。一名 13 天大的男孩被诊断为登革热。他出现癫痫发作和意识障碍,被诊断为脑炎。经过临床治疗,他完全康复出院。三个月后,他出现颅内压升高的迹象和症状。脑 MRI 显示继发于获得性导水管狭窄的脑积水。患者接受了内镜第三脑室底造瘘术。

结论

登革热感染是流行地区儿童急性发热性神经功能障碍的鉴别诊断。登革热脑炎后应提供随访,以发现可能的迟发性并发症,如脑积水。

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