Stroke in patients with dengue.
BACKGROUND
Central nervous system infections are one of the common causes of stroke in developing countries. Stroke after dengue is uncommon.


METHODS
A total of 1148 dengue cases were seen in a tertiary referral hospital during the epidemic from September to November 2008. We present 3 patients who had stroke caused by dengue. The first patient was a 45-year-old woman with dengue hemorrhagic fever who developed sudden right arm and leg weakness. Magnetic resonance imaging (MRI) revealed multiple hemorrhagic foci in the left parietal and temporal lobes. The second patient was a 35-year-old man who developed fever that was followed by altered sensorium and quadriparesis. MRI showed bilateral cerebellar hemorrhages with edema, obstructive hydrocephalus, and multiple watershed infarcts. The third patient was a 70-year-old woman who presented with giddiness for 2 days followed by sudden weakness of the left side of the body. She developed fever after admission. MRI showed infarct in the right parietal lobe. All the patients had low platelet count and one patient died.


CONCLUSIONS
Dengue might be an important cause of stroke in epidemic regions when patients present with fever, focal neurologic deficits, and encephalopathy.
Mathew
Stephen
S
Stroke Unit, Christian Medical College, Ludhiana, Punjab, India.
Pandian
Jeyaraj Durai
JD
Stroke Unit, Christian Medical College, Ludhiana, Punjab, India. Electronic address: jeyarajpandian@hotmail.com.
D000328:Adult; D000368:Aged; D001921:Brain / Q000473:pathology; D002543:Cerebral Hemorrhage / Q000150:complications / Q000209:etiology; D002544:Cerebral Infarction / Q000209:etiology / Q000473:pathology; D003715:Dengue / Q000150:complications* / Q000175:diagnosis / Q000473:pathology; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006801:Humans; D007075:Immunoglobulin M / Q000032:analysis; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D018908:Muscle Weakness / Q000209:etiology; D011782:Quadriplegia / Q000209:etiology; D020521:Stroke / Q000209:etiology* / Q000473:pathology; D016896:Treatment Outcome
D007075:Immunoglobulin M