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At the time the article was created Sarah Robertson had no recorded disclosures.View Sarah Robertson's current disclosures
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Dengue infection and dengue encephalitis, predominately occurs in tropical and subtropical areas of the world 1.
Dengue encephalitis presents similar to other forms of encephalitis with non-specific symptoms such as headache, seizures and altered level of consciousness.
Dengue virus is a mosquito-transmitted RNA virus belonging to the flavivirus genus. There are four serotypes, designated DENV1-DENV-4 1. The serotypes most commonly implicated in neurologic manifestations of dengue virus infection are DENV2 and DENV-3 2.
Dengue encephalitis typically involves the basal ganglia, thalami, cortical grey matter, and subcortical and deep white matter. Rarely, lesions are found in atypical locations such as the brainstem (particularly the substantia nigra), cerebellum, and hippocampus 1.
- hyperattenuating intraparenchymal foci representing spontaneous macrohaemorrhages 1
- T2: hyperintense
- DWI/ADC: affected regions demonstrate restricted diffusion in most cases 1
- SWI: microhemorrhages are commonly seen 1
acute disseminated encephalomyelitis (ADEM)
- hemorrhage is uncommon 1
- the timing between the CNS manifestations and lesions and the febrile illness may assist in differentiating dengue encephalitis from ADEM - with dengue encephalitis manifesting during the febrile period and ADEM occurring after resolution of the acute illness 1
- hemorrhagic findings, although described, are less common 1
- other flavivirus encephalitides
herpes simplex encephalitis
- usually spares the basal ganglia 1
- 1. Carmo RLD, Alves Simão AK, Amaral LLFD, Inada BSY, Silveira CF, Campos CMS, Freitas LF, Bonadio V, Marussi VHR. Neuroimaging of Emergent and Reemergent Infections. (2019) Radiographics : a review publication of the Radiological Society of North America, Inc. 39 (6): 1649-1671. doi:10.1148/rg.2019190020 - Pubmed
- 2. Madi D, Achappa B, Ramapuram JT, Chowta N, Laxman M, Mahalingam S. Dengue encephalitis-A rare manifestation of dengue fever. (2014) Asian Pacific journal of tropical biomedicine. 4 (Suppl 1): S70-2. doi:10.12980/APJTB.4.2014C1006 - Pubmed