Investigation of coagulation behavior using Rotational Thromboelastometry (Rotem®) in patients with neuroinfectious diseases

      Background: Neuroinfectious diseases are recognized to cause severe dysregulation on inflammation and coagulation behaviors. Dengue, one of the major infectious diseases, manifests neurological complications such as encephalitis and encephalopathy. The mosquito-borne viral infection is said to disrupt the coagulation cascade. Rotational thromboelastometry measures the interactions of coagulation factors, inhibitors and cellular components during the phases of clotting and subsequent lysis over time. Detailed analysis of coagulation parameters was investigated using thromboelastometry and standard coagulation parameter in patients with neuroinfectious diseases, such as dengue, from two different countries, i.e. Brunei Darussalam and Germany.
      Aim: The information provided by the participants will help to investigate the functional coagulation behaviour in the long term by means of the detailed analysis of coagulation parameters using thromboelastometry during the acute stage of disease.
      Methods: Blood samples were collected from patients with neuroinfectious diseases, particularly but not limited to dengue, to investigate the coagulation profiles using thromboelastometry and other standard tests.
      Results: Interim analysis and preliminary analysis indicate that lab techniques under investigation such as ROTEM® analysis reveal high abnormalities in thrombocyte function. These preliminary results indicate that thromboelastograms and laboratory techniques might be of high clinical impact in such devastating diseases.
      Conclusion: Neuroinfections are highly important – infectious of the brain and meninges may cause severe disability in patients of any age. Increasingly, comparable to stroke, in neuroinfectious disease the gold standard for survival is rapid diagnosis as basis for rapid treatment. Therefore: Time is brain.