Lora-Andosilla Mario, Almanza-Hurtado Amilkar, Rodríguez-Yáñez Tomás, Martínez-Ávila María Cristina, Dueñas-Castell Carmelo
Medicina Crítica y Cuidados Intensivos, Universidad de Cartagena, Cartagena, Colombia.
Epidemiología Clínica, Nuevo Hospital Bocagrande, Cartagena, Colombia.
Rev Chilena Infectol. 2022 Feb;39(1):91-94. doi: 10.4067/S0716-10182022000100091.
We present the case of a 32-year-old male, previously healthy, with a 5-day history of fever, frontal-occipital headache, retro-ocular pain, rash, petechiae, myalgia, arthralgia, and abdominal pain. Blood tests with leukopenia, severe thrombocytopenia, transaminitis, long clotting times. Severe dengue with associated coagulopathy was diagnosed, indicating transfer to ICU. Presents torpid evolution, altered state of consciousness, psychomotor agitation, and aggressiveness. Structural, ischemic-hemorrhagic alterations, bacterial and fungal infections were ruled out. Finally diagnosing dengue encephalitis, confirmed by DENV PCR in CSF. Support measures are provided with favorable evolution. Encephalitis is the most serious neurological complication after dengue virus infection.
我们报告一例32岁男性病例，该患者既往健康，有5天发热、额枕部头痛、眼球后疼痛、皮疹、瘀点、肌痛、关节痛和腹痛病史。血液检查显示白细胞减少、严重血小板减少、转氨酶升高、凝血时间延长。诊断为重症登革热伴相关凝血病，提示转至重症监护病房。患者病情进展缓慢，意识状态改变，有精神运动性激越和攻击性。排除了结构性、缺血性出血性改变、细菌和真菌感染。最终诊断为登革热脑炎，脑脊液登革病毒聚合酶链反应（DENV PCR）证实。给予支持措施后病情好转。脑炎是登革病毒感染后最严重的神经系统并发症。
