Acute Disseminated Encephalomyelitis Associated with Dengue Infection in Children: A Case Report and Review Literature
Vitchayaporn Emarach Saengow MD1, Oragarn Wongfukiat MD2
Affiliation : 1 Department of Pediatrics, Maharat Nakhon Ratchasima Hospital, Nakhon Ratchasima, Thailand 2 Department of Radiology, Maharat Nakhon Ratchasima Hospital, Nakhon Ratchasima, Thailand
Dengue virus, the second most common mosquito-borne disease, can manifest with wide range of neurological complications. These complications can encompass both central and peripheral nervous system. In the present study we report a 5-year-old boy diagnosed with serotype 1 [DEN-1] of dengue fever. At presentation, he had alteration of consciousness and status epilepticus along with liver failure and Reye’s syndrome. While the dengue infection and metabolic disturbance were resolved, his consciousness was not improved. Furthermore, the MRI was performed and illustrated a typical demyelinating disease. The patient was then considered as a case with dengue fever and acute disseminated encephalomyelitis [ADEM]. Following the prescription, he underwent (cid:976)ive days of therapy with pulse methylprednisolone. The neurological outcome had unexpected slow improvement. This study is in agreement with previously reported cases regarding the cytopathic effects of dengue virus on CNS. Moreover, we suggest that ADEM should be considered in the differential diagnosis in patients with dengue infection presenting encephalopathy.
Keywords : Dengue infection, Acute disseminated encephalomyelitis, ADEM, Neurological complication of dengue infection
