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Journal of Pediatric Neurology 2021; 19(02): 124-126
DOI: 10.1055/s-0040-1716344
Case Report

Dengue-Associated Posterior Reversible Encephalopathy Syndrome

Sharath M. Manya 
1   Department of Pediatrics, Kasturba Medical College, Manipal Academy of Higher Education, Mangalore, Karnataka, India
,
Soundarya Mahalingam 
1   Department of Pediatrics, Kasturba Medical College, Manipal Academy of Higher Education, Mangalore, Karnataka, India
,
Fathima Raeesa 
2   Department of Radiodiagnosis, Kasturba Medical College, Manipal Academy of Higher Education, Mangalore, Karnataka, India
,
Sathya Srivatsav 
1   Department of Pediatrics, Kasturba Medical College, Manipal Academy of Higher Education, Mangalore, Karnataka, India
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Abstract

Dengue fever has been associated with a myriad of complications, due to widespread inflammation in the various afflicted organs. Central nervous system (CNS) complications include encephalitis, encephalopathy, intracranial bleed, and spinal and cranial nerve involvement with varied outcomes. We report a case of an adolescent girl who presented with dengue fever and significant hypotension requiring intravenous fluids and vasopressors, and developed seizures on the third day of admission. Magnetic resonance imaging (MRI) of brain showed features suggestive of posterior reversible encephalopathy syndrome. She was managed conservatively with antiepileptics. She showed complete clinical recovery over the next 3 days and remained normal with seizure freedom at a recent follow-up after tapering antiepileptics.

Keywords

posterior reversible encephalopathy syndrome - dengue fever - adolescent girl


Publication History

Received: 12 June 2020

Accepted: 26 July 2020

Article published online:
04 September 2020

© 2020. Thieme. All rights reserved.

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  • References

  • 1 Guzman MG, Harris E. Dengue. Lancet 2015; 385 (9966): 453-465
    CrossrefPubMedGoogle Scholar
  • 2 Pothapregada S, Kamalakannan B, Thulasingam M. Clinical profile of atypical manifestations of dengue fever. Indian J Pediatr 2016; 83 (06) 493-499
    CrossrefPubMedGoogle Scholar
  • 3 World Health Organization. Comprehensive Guideline for Prevention and Control of Dengue and Dengue Haemorrhagic Fever. Revised and expanded edition. Accessed August 11, 2020 at: https://apps.who.int/iris/bitstream/handle/10665/204894/B4751.pdf?sequence=1&isAllowed=y
    Google Scholar
  • 4 Almeida Bentes A, Kroon EG, Romanelli RMC. Neurological manifestations of pediatric arboviral infections in the Americas. J Clin Virol 2019; 116: 49-57
    CrossrefPubMedGoogle Scholar
  • 5 Murthy JMK. Neurological complication of dengue infection. Neurol India 2010; 58 (04) 581-584
    CrossrefPubMedGoogle Scholar
  • 6 Solbrig MV, Perng GC. Current neurological observations and complications of dengue virus infection. Curr Neurol Neurosci Rep 2015; 15 (06) 29
    CrossrefPubMedGoogle Scholar
  • 7 Mai NTH, Phu NH, Nghia HDT. et al. Dengue-associated posterior reversible encephalopathy syndrome, Vietnam. Emerg Infect Dis 2018; 24 (02) 402-404
    CrossrefPubMedGoogle Scholar
  • 8 Pilato F, Distefano M, Calandrelli R. Posterior reversible encephalopathy syndrome and reversible cerebral vasoconstriction syndrome: clinical and radiological considerations. Front Neurol 2020; 11: 34
    CrossrefPubMedGoogle Scholar
  • 9 Fugate JE, Rabinstein AA. Posterior reversible encephalopathy syndrome: clinical and radiological manifestations, pathophysiology, and outstanding questions. Lancet Neurol 2015; 14 (09) 914-925
    CrossrefPubMedGoogle Scholar
  • 10 Marra A, Vargas M, Striano P, Del Guercio L, Buonanno P, Servillo G. Posterior reversible encephalopathy syndrome: the endothelial hypotheses. Med Hypotheses 2014; 82 (05) 619-622
    CrossrefPubMedGoogle Scholar
  • 11 Bartynski WS. Posterior reversible encephalopathy syndrome, part 2: controversies surrounding pathophysiology of vasogenic edema. AJNR Am J Neuroradiol 2008; 29 (06) 1043-1049
    CrossrefPubMedGoogle Scholar
  • 12 Racchiusa S, Mormina E, Ax A, Musumeci O, Longo M, Granata F. Posterior reversible encephalopathy syndrome (PRES) and infection: a systematic review of the literature. Neurol Sci 2019; 40 (05) 915-922
    CrossrefPubMedGoogle Scholar
  • 13 Halstead SB, Dans LF. Dengue infection and advances in dengue vaccines for children. Lancet Child Adolesc Health 2019; 3 (10) 734-741
    CrossrefPubMedGoogle Scholar