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Involvement of the central nervous system in dengue fever: three serologically confirmed cases from Fortaleza, Ceará, Brazil

1998; UNIVERSIDADE DE SÃO PAULO; Volume: 40; Issue: 1 Linguagem: Inglês

10.1590/s0036-46651998000100008

1678-9946

Pedro Fernando da Costa Vasconcelos, Amélia P. A. Travassos da Rosa, Ivo Castelo Branco Coêlho, Dalgimar B. de Menezes, Elizabeth Salbé Travassos da Rosa, Sueli G. Rodrigues, Jorge Fernando Soares Travassos da Rosa,

Vector-borne infectious diseases

Three cases of dengue fever involving the central nervous system (CNS) are reported. All occurred in 1994 during a dengue (DEN) epidemic caused by serotypes DEN-1 and DEN-2. The first case examined was a 17-year-old girl who complained of fever, nuchal rigidity and genital bleeding. Three blood samples were positive by anti-dengue IgM ELISA and showed hemagglutination-inhibition (HI) test titers <FONT FACE="Symbol">³</font> 1,280. The second case concerned a 86-year-old woman with fever, muscle and joint pains, altered consciousness, syncope, nuchal rigidity and meningismus. Her blood sample showed an HI titer of 1:320 for flaviviruses, and an IgM ELISA positive for dengue. The third case was a 67-year-old woman with fever, abnormal behaviour, seizures, tremor of extremities, thrombocytopenia, increased hematocrit and leukopenia. The patient suffered a typical case of dengue hemorrhagic fever with ensuing shock and a fatal outcome. A single blood sample showed HI antibodies of <FONT FACE="Symbol">³</font> 1,280 and an IgM ELISA positive for dengue. No virus could be isolated from any patient by inoculation of blood into C6/36 cells and suckling mice. No other agent of disease was encountered in the patient.