Neurotropic viruses are the most important cause of encephalitis worldwide, although
there is considerable geographical variation in the specific agents responsible. Dengue
virus threatens 40% of the global population [
[1]
], and although previously not considered a cause of encephalitis, a large body of
clinical and laboratory evidence now supports the hypothesis of dengue neurotropism
[
[2]
]. Soares et al. have shown that dengue is the most common agent of viral encephalitis
in HIV-negative adolescent and adult patients in a South American setting [
[3]
]. Their work highlights the need for validated diagnostic criteria to aid in the identification
of dengue encephalitis. In the dengue patient with signs of central nervous system
involvement, acute liver failure, shock, electrolyte derangement, and intracranial
hemorrhage should be excluded as other mechanisms of a dengue-associated encephalopathy.
The core encephalitic features of fever, headache, reduced level of consciousness,
and seizures are typically present. Neuroimaging features suggestive of viral encephalitis
may be present though are unreliable [
[4]
]. Demonstration of virus and/or antibody response in the CSF (or with lesser diagnostic
value, in the serum) confirms the diagnosis. Validation and adoption of a case definition
along these lines will aid clinical practice and research in this field.To read this article in full you will need to make a payment
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References
- Dengue haemorrhagic fever; diagnosis, treatment, prevention, and control.WHO, Geneva1997
- Encephalitis in the clinical spectrum of dengue infection.Neurol India. 2010; 58: 585-591
- Review of the etiologies of viral meningitis and encephalitis in a dengue endemic region.J Neurol Sci. 2011; 303: 75-79
- Usefulness of various MRI sequences in the diagnosis of viral encephalitis.Acta Trop. 2010; 116: 206-211
Article info
Publication history
Published online: April 25, 2011
Accepted:
April 4,
2011
Received:
February 28,
2011
Identification
Copyright
© 2011 Elsevier B.V. Published by Elsevier Inc. All rights reserved.