title: Japanese Encephalitis Complicated with Obstructive Hydrocephalus.
abstract: Japanese Encephalitis (JE), caused by Japanese encephalitis virus (JEV), a flavi-virus, is the most significant aetiology of arboviral encephalitis worldwide. It has resulted in epidemics of encephalitis in the Indian subcontinent. Here, we report a case of 36-year-old female who presented with a short history of fever and headache followed by altered sensorium. Funduscopic examination revealed Papilloedema. Pyogenic or viral meningoencephalitis along with complicated malaria were kept as initial differential diagnosis. Magnetic Resonance Imaging (MRI) of brain revealed involvement of posterior limb of internal capsule and bilateral thalami in the form of haemorrhagic encephalitis along with obstructive hydrocephalus. Cerebro Spinal Fluid (CSF) serology (IgM ELISA) showed JE as the causative agent. Despite extensive literature search, we could not find a case of JE reported with hydrocephalus as a complication. This case highlights the typical and atypical features of JE including imaging findings and exemplifies the way, how diversely JE can present and would thus help in preparing management paradigms accordingly.
authors.affiliation: Assistant Professor, Department of Medicine, Lady Hardinge Medical College , New Delhi, India .
authors.forename: Vivek
authors.initials: V
authors.lastname: Suman
authors.affiliation: Junior Resident, Department of Medicine, University College of Medical Sciences , Delhi, India .
authors.forename: Ujjawal
authors.initials: U
authors.lastname: Roy
authors.affiliation: Senior Resident, Department of Neurology, Vardhman Mahavir Medical College and Safdarjung Hospital , New Delhi, India .
authors.forename: Ajay
authors.initials: A
authors.lastname: Panwar
authors.affiliation: Assistant Professor, Department of Medicine, University College of Medical Sciences , Delhi, India .
authors.forename: Alpana
authors.initials: A
authors.lastname: Raizada
keywords: Culex; Elevated intracranial pressure; Flavivirus; Haemorrhagic encephalitis; Herniation syndromes