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- Title
Neuroradiology. Acute hemorrhagic encephalitis: An unusual presentation of dengue viral infection.
- Authors
Nadarajah, Jeyaseelan; Madhusudhan, Kumble Seetharama; Yadav, Ajay Kumar; Gupta, Arun Kumar; Vikram, Naval Kishore
- Abstract
Dengue is a common viral infection worldwide with presentation varying from clinically silent infection to dengue fever, dengue hemorrhagic fever, and severe fulminant dengue shock syndrome. Neurological manifestation usually results from multisystem dysfunction secondary to vascular leak. Presentation as hemorrhagic encephalitis is very rare. Here we present the case of a 13-year-old female admitted with generalized tonic clonic seizures. Plain computed tomography (CT) scan of head revealed hypodensities in bilateral deep gray matter nuclei and right posterior parietal lobe without any hemorrhage. Cerebrospinal fluid (CSF) and serology were positive for IgM and IgG antibodies to dengue viral antigen. Contrast-enhanced magnetic resonance imaging (MRI) revealed multifocal T2 and fluid attenuated inversion recovery (FLAIR) hyperintensities in bilateral cerebral parenchyma including basal ganglia. No hemorrhage was seen. She was managed with steroids. As her clinical condition deteriorated, after being stable for 2 days, repeat MRI was done which revealed development of hemorrhage within the lesions, and diagnosis of acute hemorrhagic encephalitis of dengue viral etiology was made.
- Subjects
BRAIN; RADIOGRAPHY; MAGNETIC resonance imaging evaluation; CEREBRAL hemorrhage; ACUTE diseases; VIRAL encephalitis; DENGUE; DIFFERENTIAL diagnosis; SYMPTOMS; DISEASE complications; DIAGNOSIS
- Publication
Indian Journal of Radiology & Imaging, 2015, Vol 25, Issue 1, p52
- ISSN
0971-3026
- Publication type
Article
- DOI
10.4103/0971-3026.150145