Abstract
Background
Dengue is the leading cause of mosquito-borne viral infection. It is responsible for high morbidity and mortality in children living in endemic areas. Nowadays, neurological complications are progressively referred to and include a broad spectrum of symptoms. It can be secondary to metabolic alterations, direct invasion by the virus, and enhanced autoimmune response.
Case presentation
Here, we report a rare case of hydrocephalus secondary to dengue encephalitis. A 13-day-old boy was diagnosed with dengue. He evolved with seizures and impaired consciousness being diagnosed with encephalitis. After clinical treatment, he was discharged fully recovered. Three months later, he presented with signs and symptoms of intracranial hypertension. Brain MRI revealed hydrocephalus secondary to acquired aqueduct stenosis. The patient underwent an endoscopic third ventriculocisternostomy.
Conclusion
Dengue infection is a differential diagnosis for acute febrile neurological impairment in children from endemic areas. Follow-up should be offered after dengue encephalitis to detect possible late-onset complications, as hydrocephalus.
Similar content being viewed by others
Data availability
Not applicable.
References
Murray NEA, Quam MB, Wilder-Smith A (2013) Epidemiology of dengue: past, present and future prospects. Clin Epidemiol 5:299–309. https://doi.org/10.2147/CLEP.S34440
World Health Organization (2012) Global strategy for dengue prevention and control, 2012–2020
Verma R, Sahu R, Holla V (2014) Neurological manifestations of dengue infection: a review. J Neurol Sci 346:26–34. https://doi.org/10.1016/j.jns.2014.08.044
World Health Organization (2009) Dengue guidelines for diagnosis, treatment, prevention and control: new edition
Li G-H, Ning Z-J, Liu Y-M, Li X-H (2017) Neurological manifestations of dengue infection. Front Cell Infect Microbiol 7:1–17. https://doi.org/10.3389/fcimb.2017.00449
Carod-Artal FJ, Wichmann O, Farrar J, Gascón J (2013) Neurological complications of dengue virus infection. Lancet Neurol 12:906–919. https://doi.org/10.1016/S1474-4422(13)70150-9
Murthy JMK (2010) Neurological complication of dengue infection. Neurol India 58:581–584. https://doi.org/10.4103/0028-3886.68654
Brito Ferreira ML, Gomes Cavalcanti C, Alvarenga Coelho C, Dornelas Mesquita S (2005) Neurological manifestations of dengue: study of 41 cases. Arq Neuropsiquiatr 63:488–493
Puccioni-Sohler M, Rosadas C, Cabral-Castro MJ (2013) Neurological complications in dengue infection: a review for clinical practice. Arq Neuropsiquiatr 71:667–671. https://doi.org/10.1590/0004-282X20130147
Arishi HM, Ageel AA, Al Najmi MI et al (2020) Dengue meningoencephalitis in a child presenting with focal seizures. Int J Pediatr Adolesc Med 355:1053–1059. https://doi.org/10.1016/j.ijpam.2020.01.007
Cam B, Fonsmark L, Hue N et al (2001) Prospective case control study of encephalopathy in children with dengue hemorrhagic fever. Am J Trop Med Hyg 65:848–851
Domingues RB, Kuster GW, Onuki-Castro FL et al (2008) Involvement of the central nervous system in patients with dengue virus infection. J Neurol Sci 267:36–40. https://doi.org/10.1016/j.jns.2007.09.040
Osnaya-Romero N, Perez-Guille MG, Andrade-García S et al (2017) Neurological complications and death in children with dengue virus infection: report of two cases. J Venom Anim Toxins Incl Trop Dis 23:25. https://doi.org/10.1186/s40409-017-0115-x
Miagostovich MP, Ramos RG, Nicol AF, Nogueira RM, Cuzzi-Maya T, Oliveira AV, Marchevsky RS, Mesquita RP, Schatzmayr HG (1997) Retrospective study on dengue fatal cases. Clin Neuropathol 16:204–208
Solomon T, Dung NM, Vaughn DW et al (2000) Neurological manifestations of dengue infection. Lancet 355:1053–1059. https://doi.org/10.1016/S0140-6736(00)02036-5
Kamble RB, Venkataramana NK, Raghunath CN (2011) Dengue encephalitis associated with hydrocephalus: a case report. Neuroradiol J 24:833–837. https://doi.org/10.1177/197140091102400601
Poletti M, Sousa C, Sampaio M (2016) Evidencias de transmisión vertical de arbovirus. Residência Pediátrica 6:21–24. https://doi.org/10.25060/residpediatr-2016.v6n1-04
Jain A, Chaturvedi UC (2010) Dengue in infants: an overview. FEMS Immunol Med Microbiol 59:119–130. https://doi.org/10.1111/j.1574-695X.2010.00670.x
Varatharaj A (2010) Encephalitis in the clinical spectrum of dengue infection. Neurol India 58:585–591. https://doi.org/10.4103/0028-3886.68655
Soares C, Puccioni-Sohler M (2014) Diagnosis criteria of dengue encephalitis. Arq Neuropsiquiatr 72:263. https://doi.org/10.1590/0004-282X20130251
Araújo F, Nogueira R, Araújo M d S et al (2012) Dengue in patients with central nervous system manifestations, Brazil. Emerg Infect Dis 18:677–679. https://doi.org/10.3201/eid1804.111552
Hegde V, Aziz Z, Kumar S et al (2015) Dengue encephalitis with predominant cerebellar involvement: report of eight cases with MR and CT imaging features. Eur Radiol 25:719–725. https://doi.org/10.1007/s00330-014-3473-6
Wasay M, Channa R, Jumani M et al (2008) Encephalitis and myelitis associated with dengue viral infection. Clinical and neuroimaging features. Clin Neurol Neurosurg 110:635–640. https://doi.org/10.1016/j.clineuro.2008.03.011
Bhoi SK, Naik S, Kumar S et al (2014) Cranial imaging findings in dengue virus infection. J Neurol Sci 342:36–41. https://doi.org/10.1016/j.jns.2014.04.018
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of interest
The authors declare that there is no conflict of interest.
Code availability
Not applicable.
Additional information
Publisher’s note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
About this article
Cite this article
Morais, B.A., Pereira, N.M., Franco, C.L. et al. Hydrocephalus secondary to dengue encephalitis in an infant: case report. Childs Nerv Syst 37, 2357–2361 (2021). https://doi.org/10.1007/s00381-020-04876-0
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00381-020-04876-0