Dengue Fever Can Have Severe Neurological Manifestations

Contrary to common belief, a team of researchers in Secunderabad, India, has found that dengue fever can be neurotropic.

Dengue fever, a common tropical disease is a global threat and in the US has become endemic in Florida.

The mosquito-borne malady is generally considered not to be neurotropic. A team of researchers in Secunderabad, India sought to learn if that is really the case.

Since thousands of cases of dengue fever and hundreds of cases of dengue hemorrhagic fever occur in India every year, the team was able to concentrate on patients at a single center, the Krishna Institute of Medical Sciences in Hyderabad.

Reporting in an abstract presented April 19 at the American Academy of Neurology 2015 annual meeting in Washington, DC, Devashish Ruikar, MD, and colleagues offered their findings.

Contrary to the prevailing belief, the team found that of 281 patients with acute dengue fever or dengue hemorrhagic fever admitted to the hospital, 31 patients (11.8%) had neurological symptoms.

The mean Glasgow Coma Scale (GSC) score on admission was 11.8. Those whose GSC scores showed the most impairment were more likely to have longer stays and more severe illness.

The researchers concluded that Dengue fever should be considered a differential diagnosis in patients with fever, thrombocytopenia and recent-onset neurological deterioration. It should also be considered a possibility in patients with encephalitis or encephalopathy of unknown cause.

They also suggest that MRI is a useful aid in diagnosis, and that the GCS score is an important prognostic factor.