Berdiñas Anfuso Melany, Gonzalez María Victoria, Schverdfinger Sofía, Videla Carlos G, Ciarrocchi Nicolás M
Servicio de Terapia Intensiva de Adultos, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina.
Servicio de Terapia Intensiva de Adultos, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina. E-mail:
Medicina (B Aires). 2024;84(4):780-783.
Dengue virus is an endemic virus in Argentina that, although it was initially considered to be non-neurotropic, it is currently recognized to be neuroinvasive; thus conditioning a prevalence of neurological manifestations of up to 15% among patients. Even being considered severe symptoms, there is underdiagnoses of dengue encephalitis due to its varied clinical presentation. Neurological manifestations of dengue encephalitis can range from fever and headache to altered levels of consciousness and seizures. Although the cerebrospinal fluid may be normal in up to a third of cases, it usually presents increased protein concentration and pleocytosis. Regarding neuroimaging methods, the findings are usually varied and nonspecific, and can even be normal in up to 40-50% of cases. We present three cases of dengue encephalitis diagnosed in a university hospital in Buenos Aires, Argentina, where the clinical presentation varied from temporal-spatial disorientation to refractory convulsive status with different presentations in the cerebrospinal fluid but all with positive PCR for dengue in it and with normal neuroimaging.
登革病毒是阿根廷的一种地方性病毒，尽管它最初被认为是非嗜神经性的，但目前已被确认为具有神经侵袭性；因此，患者中神经症状的患病率可达15%。即使被视为严重症状，由于登革热脑炎临床表现多样，其诊断仍不足。登革热脑炎的神经症状范围从发热、头痛到意识水平改变和癫痫发作。虽然高达三分之一的病例脑脊液可能正常，但通常会出现蛋白质浓度升高和细胞增多。关于神经影像学检查方法，结果通常多样且无特异性，甚至在40%-50%的病例中可能正常。我们报告了在阿根廷布宜诺斯艾利斯一家大学医院诊断的3例登革热脑炎病例，其临床表现从时空定向障碍到难治性惊厥持续状态不等，脑脊液表现不同，但所有病例的脑脊液登革热PCR检测均为阳性，神经影像学检查正常。
