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Revista Cubana de Medicina Tropical

On-line version ISSN 1561-3054

Abstract

SANTOS MARTINEZ, Ángel Miguel; GUEVARA ENG, Yamel; CALAS HECHAVARRIA, Vianka  and  NAVARRETE BALDASSARRI, Ivon Zoila. Postinfectious acute disseminated encephalomyelitis in a patient with suspected dengue virus infection. Rev Cubana Med Trop [online]. 2019, vol.71, n.1  Epub June 30, 2019. ISSN 1561-3054.

Introduction:

Dengue virus infection is one of the most prevalent arboviruses in tropical countries. Acute disseminated encephalomyelitis is an inflammatory demyelinating multifocal disorder affecting the central nervous system. Its onset is acute and its clinical course monophasic. The inflammatory process is mediated by immunological mechanisms, and its relationship to dengue virus infections is still not clear.

Objective:

Describe a clinical case of central nervous system manifestations after probable dengue virus infection.

Case presentation:

Female 50-year-old patient with a history of controlled hypertension. Fifteen days after a 4-day fever episode, possibly due to dengue virus infection, the patient starts presenting neurological signs and symptoms, such as slight irritability and difficulty to concentrate on a specific activity of daily living. The patient notices progressive motor difficulty in her left hemibody and she feels agitated and distracted. It is therefore decided for her to be hospitalized. A diagnosis is made based on physical examination findings, positive nuclear magnetic resonance studies, and the positive result of the dengue IgM blood test. Both the patient's clinical evolution and her response to treatment with steroids were favorable.

Conclusions:

The event herein described suggests that physicians should consider the diagnosis of acute disseminated encephalomyelitis in patients with previous infection or high suspicion of infection with dengue virus.

Keywords : acute disseminated encephalomyelitis (ADEM); central nervous system (CNS); peripheral nervous system (PNS); nuclear magnetic resonance (NMR).

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