International Journal of Research in Medical Sciences | June 2020 | Vol 8 | Issue 6 Page 1
International Journal of Research in Medical Sciences
Dhar SK et al. Int J Res Med Sci. 2020 Jun;8(6):xxx-xxx
www.msjonline.org pISSN 2320-6071 | eISSN 2320-6012
Original Research Article
Cerebrospinal fluid analysis in dengue in a tertiary care center
Srikant Kumar Dhar, Udaybhanu Rout*, Naqash Nadar Suse, Nikhil Rajendra Arve,
Naresh Yennam, Rakesh Keshari Swain
INTRODUCTION
Dengue is found in tropical and subtropical areas around
the world, predominantly in urban and semi-urban
regions.
1
The disease is caused by a virus due to family
Flaviviradae that is spread by Aedesmosquitoes.
2
Some 2.5 billion people two fifths of the world's
population in tropical and subtropical countries are at risk
and an estimated 50 million dengue infections occur
worldwide annually.
3,4
Dengue and DHF is endemic in more than hundred
countries in the WHO regions of Africa, the Americas, the
Eastern Mediterranean, the Western Pacific and east Asia
but The South East Asia and Western Pacific regions are
the most seriously affected.
4
Epidemics of dengue are
rising in frequency. During epidemics, infection rates
among those who have not been previously exposed to the
virus are often 40% to 50% but can also increase to 80%
to 90%.
Some recent reports indicate that the clinical profile of
dengue is changing. Neurological manifestations are being
reported very frequently. While the actual incidence of
various neurological complications is not certain, the
reported incidence of encephalopathy and encephalitis, the
most common neurological manifestations of dengue.
Department of Medicine, IMS and SUM Hospital, Siksha “O” Anusandhan University, K8, Kalinganagar, Bhubaneswar,
Odisha, India
Received: 18 April 2020
Accepted: 29 April 2020
*Correspondence:
Dr. Udaybhanu Rout,
E-mail: udaybhanu.rout@gmail.com
Copyright: © the author(s), publisher and licensee Medip Academy. This is an open-access article distributed under
the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial
use, distribution, and reproduction in any medium, provided the original work is properly cited.
ABSTRACT
Background: Clinical profile of dengue is variable including neurological manifestations like encephalopathy and
encephalitis which are not being reported very frequently. This study is an attempt to know the cerebrospinal fluid
(CSF) finding in dengue infected patients with neurological manifestations in a tertiary care hospital Eastern Odisha.
Methods: Study conducted from August 2018 to July 2019 comprising of 100 dengue seropositive (NS1/IgM/IgG)
patients of age >15 years in IMS and SUM Hospital.
Results: A total of 100 (66 boys and 34 girls) hospitalised patients (Age >15 years) diagnosed as dengue were enrolled
in our study. Total 20 cases Cerebrospinal fluid analysis has been done in which we found 70% (13 cases) unclassified
viral meningitis, 15% (3 cases) bacterial meningitis, 5% (1 case) tuberculous meningitis, 5% (1 case) herpes encephalitis
and 5% (1 case) Japanese encephalitis. Neurological manifestations in all dengue sero positive cases (100) found 30%
headache, 18% altered sensorium, 5% seizure, 4% syncope, 3% papilloedema, 1% CN palsy and 11% meningeal signs.
Conclusions: Dengue meningoencephalitis must be thought of in differentials of all febrile encephalopathy. This study
brings out the incidence of different meningoencephalitis on the bases of CSF analysis including coinfections. So in
dengue patients with neurological manifestation should do CSF analysisfor better outcome of a disease.
Keywords: Cerebrospinal fluid, Dengue, Headache, Meningeal signs, Meningoencephalitis, Neurological
manifestations
DOI: http://dx.doi.org/10.18203/2320-6012.ijrms20202046