Involvement of the central nervous system in dengue fever: three serologically confirmed cases from Fortaleza Ceará, Brazil.
Three cases of dengue fever involving the central nervous system (CNS) are reported. All occurred in 1994 during a dengue (DEN) epidemic caused by serotypes DEN-1 and DEN-2. The first case examined was a 17-year-old girl who complained of fever, nuchal rigidity and genital bleeding. Three blood samples were positive by anti-dengue IgM ELISA and showed hemagglutination-inhibition (HI) test titers > or = 1,280. The second case concerned a 86-year-old women with fever, muscle and joint pains, altered consciousness, syncope, nuchal rigidity and meningismus. Her blood sample showed an HI titer of 1:320 for flaviviruses, and an IgM ELISA positive for dengue. The third case was a 67-year-old women with fever, abnormal behaviour, seizures, tremor of extremities, thrombocytopenia, increased hematocrit and leukopenia. The patient suffered a typical case of dengue hemorrhagic fever with ensuing shock and a fatal outcome. A single blood sample showed HI antibodies of > or = 1,280 and an IgM ELISA positive for dengue. No virus could be isolated from any patient by inoculation of blood into C6/36 cells and suckling mice. No other agent of disease was encountered in the patient.
WHO Collaborating Center for Arbovirus Reference and Research, Instituto Evandro Chagas, Belém, PA, Brasil.
P F
PF
Vasconcelos
A P
AP
da Rosa
I C
IC
Coelho
D B
DB
Menezes
E S
ES
da Rosa
S G
SG
Rodrigues
J F
JF
da Rosa
D000293:Adolescent; D000368:Aged; D000369:Aged, 80 and over; D001792:Blood Platelets; D001794:Blood Pressure; D002493:Central Nervous System Diseases / Q000821:virology*; D003715:Dengue / Q000097:blood / Q000150:complications* / Q000175:diagnosis; D005260:Female; D006400:Hematocrit; D006801:Humans; D007958:Leukocyte Count; D013997:Time Factors