Hussain Hassan, Janaka K V C, Gunasekara Harsha, Krishnan Manojkumar, Perera Isuru
General Medicine, Sri Jayewardenepura General Hospital, Colombo, LKA.
Internal Medicine, Sri Jayewardenepura General Hospital, Colombo, LKA.
Cureus. 2024 Mar 6;16(3):e55628. doi: 10.7759/cureus.55628. eCollection 2024 Mar.
Dengue is an infection with a wider spectrum of disease manifestations, ranging from simple dengue fever to expanded dengue syndrome. Expanded dengue syndrome encompasses multiorgan involvement, including neurological manifestations such as dengue encephalitis, seizures, encephalopathy, coma, hemiparesis, etc. Herein, we present a case of a 50-year-old female with a background history of well-controlled type 2 diabetes mellitus and hypertension for five years on oral medication. The patient presented with a one-day history of altered levels of consciousness, agitation, and aggressive behavior. Before admission, she had a history of high-grade fever with chills and rigors for three days. Serial investigations were performed, and the diagnosis of dengue encephalitis was made amidst the absence of positive findings for encephalitis in most of the imaging modalities except in electroencephalogram (EEG), making this case unique. Initially, it was presumed to be meningoencephalitis. Hence, the patient was initiated on intravenous acyclovir and cefotaxime. After the definitive diagnosis of dengue encephalitis, the given medication was stopped after seven days of administration, and with supportive management, the patient made a successful recovery within 10 days.
登革热是一种具有更广泛疾病表现谱的感染性疾病,从单纯的登革热发热到重症登革热综合征。重症登革热综合征包括多器官受累,其中包括神经系统表现,如登革热脑炎、癫痫发作、脑病、昏迷、偏瘫等。在此,我们报告一例50岁女性病例,该患者有2型糖尿病和高血压病史,口服药物控制良好,病史长达5年。患者出现意识水平改变、烦躁不安和攻击性行为1天。入院前,她有高热伴寒战和抽搐3天的病史。进行了一系列检查,除脑电图(EEG)外,大多数影像学检查均未发现脑炎的阳性结果,但仍诊断为登革热脑炎,使该病例具有独特性。最初,推测为脑膜脑炎。因此,患者开始静脉注射阿昔洛韦和头孢噻肟。在确诊为登革热脑炎后,给药7天后停用给定药物,经过支持治疗,患者在10天内成功康复。