title: Meningitis determined by oligosymptomatic dengue virus type 3 infection: report of a case.
abstract: Dengue infection is a mosquito-borne disease caused by a flavivirus, and is recognized in over 100 countries with 2.5 billion people living in areas of risk. Neurological manifestations such as encephalitis, myelitis, Guillain-Barré syndrome, cranial nerve palsies, neuromyelitis optica, and encephalomyelitis have been recognized as clinical consequences of dengue infection. Meningitis is a rare complication. We report the case of a 24-year-old woman who presented with fever, headache, and nuchal rigidity without the typical symptoms of dengue infection. Cerebrospinal fluid analysis showed lymphocytic pleocytosis with a normal glucose value and negative bacterial and fungal cultures. The etiology of meningitis was confirmed by positive dengue PCR in the serum. This case report highlights dengue infection as a potential cause of meningitis in endemic areas. Also, meningitis can be the first manifestation of the infection. Dengue should be investigated even in the absence of a typical picture of the infection.
authors.affiliation: Neurology Service, Hospital Universitário Antônio Pedro/Universidade Federal Fluminense, Rio de Janeiro, Brazil. cnsoares@predialnet.com.br
authors.forename: C N
authors.initials: CN
authors.lastname: Soares
authors.forename: M J
authors.initials: MJ
authors.lastname: Cabral-Castro
authors.forename: J M
authors.initials: JM
authors.lastname: Peralta
authors.forename: M R G
authors.initials: MR
authors.lastname: Freitas
authors.forename: M
authors.initials: M
authors.lastname: Puccioni-Sohler
mesh_terms: D000328:Adult; D002555:Cerebrospinal Fluid / Q000821:virology; D003715:Dengue / Q000150:complications* / Q000175:diagnosis / Q000821:virology; D003716:Dengue Virus / Q000145:classification / Q000235:genetics* / Q000302:isolation & purification; D005260:Female; D006801:Humans; D008587:Meningitis, Viral / Q000134:cerebrospinal fluid / Q000175:diagnosis / Q000821:virology; D020133:Reverse Transcriptase Polymerase Chain Reaction; D055815:Young Adult