IP International Journal of Medical Paediatrics and Oncology 2020;6(4):169–171 Content available at: https://www.ipinnovative.com/open-access-journals IP International Journal of Medical Paediatrics and Oncology Journal homepage: https://www.ipinnovative.com/journals/IJMPO Case Report Dengue virus and Japanese encephalitis virus co-infection: A case report Rishi Kathuria 1 , Pallavi Choudhary 1 , Archana Kashyap 1 , Entesham Ansari 2 , Murtaza Kamal 3, * 1 Dept. of Pediatrics, Safdarjung Hospital, New Delhi, India 2 Dept. of Peadiatric Cardiology, Nestiva Hospital, Patna, Bihar, India 3 Dept. of Pediatric Cardiology, R&R Multispeciality Hospital, Jhunjhunu, Rajasthan, India ARTICLE INFO Article history: Received 13-11-2020 Accepted 30-12-2020 Available online 09-01-2021 Keywords: Arboviruses Dengue virus Japanese encephalitis Dengue JE coinfection India ABSTRACT Dengue and Japanese Encephalitis both are caused by Arboviruses spread by mosquitoes are important causes of mortality and morbidity in India. Very few cases of their co-infection have been reported in endemic countries but these is no case report in paediatric population to the best of our knowledge. We report the case of a 4 years old girl child who presented to us with fever, seizures and subsequently developing altered mental status. Lab and radiological investigations proved Dengue and JE co-infection in this child. © This is an open access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/) which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. 1. Introduction Dengue and Japanese encephalitis are major causes of morbidity and mortality in tropical and subtropical parts of world including India. It is estimated that there are 390 million dengue infections annually, and recently the number of dengue cases has increased exponentially worldwide. 1 Dengue is endemic in almost all over India (31 states/UTs). All 4 serotypes of Dengue virus have been isolated while JE is endemic in 18 states of India of which include Assam, Bihar, Haryana, Uttar Pradesh, Karnataka, West Bengal & Tamil Nadu report out-breaks almost every year and contribute to 80% cases and deaths. Both being Arboviral diseases (Group B-Flaviviruses) are spread by bite of infected mosquitoes. They cross react with other in serological tests. Dengue virus usually causes classical dengue fever, DHF and DSS, JE virus typically causes encephalitis. In rare instances, Dengue virus may also cause encephalitis mimicking JE. Lab investigations therefore * Corresponding author. E-mail address: murtaza.vmmc@gmail.com (M. Kamal). becomes essential for confirmation and discrimination between these two viral infections. 2. Case Report A 4 year old girl child resident of Faridabad, Haryana presented to us with chief complaints of high grade fever (102 ◦ F), not associated with chills and rigors for last 4 days, abnormal body movements with up rolling of eyeballs for last 3 days followed by altered mental status, not recognising parents, not responding, not vocalizing or indicating bowel bladder. This was associated with loose stools and vomiting for last 1 day. There was no history of rash, bleeding from any site, cough or coryza. No history of any limb weakness or any cranial nerve deficit. She had not received any medication in recent past and no history of any Koch’s contact. Developmentally normal child with immunization complete for age. At presentation, GCS was E1V3M4 and respiratory functions and hemodynamic parameters were stable. Neurological examination revealed altered state of https://doi.org/10.18231/j.ijmpo.2020.039 2454-4399/© 2020 Innovative Publication, All rights reserved. 169