Dengue encephalitis
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Dengue encephalitis is a rare condition resulting from direct involvement of the central nervous system by the dengue virus.
Epidemiology
Dengue infection, and thus dengue encephalitis, predominately occurs in tropical and subtropical areas. 1
Clinical Presentation
Dengue encephalitis presents similar to other forms of encephalitis with non-specific symptoms such as headache, seizures and altered level of consciousness.
Pathology
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
Radiographic Features
CT
- hyperattenuating intraparenchymal foci representing spontaneous macrohaemorrhages 1
MRI
-
T2
- hyperintense lesions involving the basal ganglia, thalami, cortical grey matter, and subcortical and deep white matter are the classical features of dengue encephalitis, usually with associated oedema
- rarely, similar lesions are found in atypical locations such as the brainstem (particularly the substantia nigra), cerebellum, and hippocampus 1
- DWI/ADC: affected regions demonstrate restricted diffusion in most cases 1
- SWI: microhaemorrhages are commonly seen 1
Differential Diagnosis
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acute disseminated encephalomyelitis (ADEM)
- haemorrhage 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
-
Japanese encephalitis
- haemorrhagic findings, although described, are less common 1
-
herpes simplex encephalitis
- usually spares the basal ganglia 1
-<p><strong>Dengue encephalitis</strong> is a rare condition resulting from direct involvement of the central nervous system by the dengue virus. </p><h4>Epidemiology</h4><p>Dengue infection, and thus dengue encephalitis, predominately occurs in tropical and subtropical areas. <sup>1</sup> </p><h4>Clinical Presentation</h4><p>Dengue encephalitis presents similar to other forms of encephalitis with non-specific symptoms such as headache, seizures and altered level of consciousness. </p><h4>Pathology</h4><p>Dengue virus is a mosquito-transmitted RNA virus belonging to the <em>Flavivirus </em>genus. There are four serotypes, designated DENV1-DENV-4. <sup>1</sup> The serotypes most commonly implicated in neurologic manifestations of dengue virus infection are DENV2 and DENV-3. <sup>2</sup></p><h4>Radiographic Features</h4><p><strong>CT</strong></p><ul><li>hyperattenuating intraparenchymal foci representing spontaneous macrohaemorrhages <sup>1</sup>- +<p><strong>Dengue encephalitis</strong> is a rare condition resulting from direct involvement of the central nervous system by the dengue virus. </p><h4>Epidemiology</h4><p><a title="Dengue" href="/articles/dengue">Dengue</a> infection, and thus dengue encephalitis, predominately occurs in tropical and subtropical areas. <sup>1</sup> </p><h4>Clinical Presentation</h4><p>Dengue encephalitis presents similar to other forms of encephalitis with non-specific symptoms such as headache, seizures and altered level of consciousness. </p><h4>Pathology</h4><p>Dengue virus is a mosquito-transmitted RNA virus belonging to the <em>Flavivirus </em>genus. There are four serotypes, designated DENV1-DENV-4. <sup>1</sup> The serotypes most commonly implicated in neurologic manifestations of dengue virus infection are DENV2 and DENV-3. <sup>2</sup></p><h4>Radiographic Features</h4><p><strong>CT</strong></p><ul><li>hyperattenuating intraparenchymal foci representing spontaneous macrohaemorrhages <sup>1</sup>
-<a title="Acute disseminated encephalomyelitis (ADEM)" href="/articles/acute-disseminated-encephalomyelitis-adem-1">acute disseminated encephalomyelitis (ADEM)</a><ul>- +<a href="/articles/acute-disseminated-encephalomyelitis-adem-1">acute disseminated encephalomyelitis (ADEM)</a><ul>
-<a title="Japanese encephalitis" href="/articles/japanese-encephalitis">Japanese encephalitis</a> <ul><li>-<a title="Acute disseminated encephalomyelitis (ADEM)" href="/articles/acute-disseminated-encephalomyelitis-adem"></a>haemorrhagic findings, although described, are less common <sup>1</sup>- +<a href="/articles/japanese-encephalitis">Japanese encephalitis</a> <ul><li>
- +<a href="/articles/acute-disseminated-encephalomyelitis-adem"></a>haemorrhagic findings, although described, are less common <sup>1</sup>
-<a title="Herpes simplex encephalitis" href="/articles/herpes-simplex-encephalitis">herpes simplex encephalitis</a><ul><li>usually spares the basal ganglia <sup>1</sup>- +<a href="/articles/herpes-simplex-encephalitis">herpes simplex encephalitis</a><ul><li>usually spares the basal ganglia <sup>1</sup>
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