Yoosuf Husna, Alawneh Josef A, Hashim Zafar, Fatima Umama B, Dara Saqib I
College of Medicine, Gulf Medical University, Ajman, UAE.
Department of Neurology, Sheikh Shakhbout Medical City, Abu Dhabi, UAE.
BMC Neurol. 2025 Apr 26;25(1):185. doi: 10.1186/s12883-025-04197-2.
Dengue encephalitis is a rare complication of dengue and can manifest as ischemic stroke, making the diagnosis challenging. This case highlights the need of recognizing unusual presentation of dengue and the use of neuroradiology in its diagnosis.
A previously healthy 38-years-old man presented to the emergency department with weakness of the left upper limb and bilateral lower limbs, aphasia and confusion. He had flu-like symptoms along with fever for the past 3 days. Magnetic Resonance Imaging (MRI) of the brain showed hyperintensities in the bilateral thalamic and parafalcine regions. The patient was started on aspirin for the suspicion of ischemic stroke. But the patient's condition deteriorated. Lumbar puncture did not reveal any evidence of meningitis. The blood Reverse Transcription Polymerase Chain Reaction (RT-PCR) confirmed the diagnosis of dengue hemorrhagic fever.
This article emphasizes the importance of including the complications and manifestations of dengue fever in the differential diagnosis of ischemic stroke in a relevant context. Unique radiological finding of bilateral thalamic lesions can serve as important diagnostic clues in such atypical cases. Early diagnosis can help guide therapy.
登革热脑炎是登革热的一种罕见并发症，可表现为缺血性中风，这使得诊断具有挑战性。该病例强调了认识登革热异常表现以及神经放射学在其诊断中的应用的必要性。
一名38岁既往健康的男性因左上肢及双侧下肢无力、失语和意识模糊就诊于急诊科。过去3天他有类似流感的症状并伴有发热。脑部磁共振成像（MRI）显示双侧丘脑和大脑镰旁区域有高信号。因怀疑缺血性中风，患者开始服用阿司匹林。但患者病情恶化。腰椎穿刺未发现任何脑膜炎证据。血液逆转录聚合酶链反应（RT-PCR）确诊为登革出血热。
本文强调在相关背景下，将登革热的并发症和表现纳入缺血性中风鉴别诊断的重要性。双侧丘脑病变独特的放射学表现可作为此类非典型病例的重要诊断线索。早期诊断有助于指导治疗。
