A case of dengue encaphelitis
Published in the Journal of the Association of Physicians of India, the authors report a case of dengue encephalitis who was IgM positive for dengue serology and had presented to with only motor weakness after an acute febrile episode. Dengue presenting as encephalitis is in itself a very rare feature and that too, pure motor weakness has hardly ever been reported before.

A 38 years old previously healthy male presented to us with fever (100-102° F) since 7 days and weakness of left arm and leg since 2 days. His fever used to get relieved with paracetamol. Five days after the onset of fever he had 2-3 episodes of vomiting followed by loss of consciousness which lasted for about 20 to 30 minutes.

This was associated with clenching of teeth and tightening of limbs. On regaining consciousness the patient noted left sided weakness. Urgent CT brain raised suspicious of an inflammatory granuloma in right high parietal region with edema. His platelet count was 59000 cumm with NS1 positive for dengue by ELISA.

Other blood parameters were within normal limits. There was no history of petechiae or bleeding from any site and his vital parameters were stable. Therefore, he came to our hospital where he was admitted as a case of dengue with left hemiplegia. There was no history of bleeding from any site. He was conscious, cooperative, well oriented in time, place and person. BP - 120/80 mm Hg, temperature- 100° F, pulse -90 beats /min.

On nervous system examination -power was 0/5 in both left upper and lower limbs and 5/5 in right upper and lower limbs. Left plantar showed absent and right plantar showed flexor response. B/L pupils had normal size with normal reaction to light and no cranial nerve deficit. There were no meningeal signs or any sensory loss. Gait and coordination could not be assessed. Other systems had no significant findings.

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S●●●●●v P●●●●●●●●●n
S●●●●●v P●●●●●●●●●n General Medicine
Sahi hai
Nov 1, 2018Like
Dr. DR H●●. C●●●●●●●●●●I H●●●●●I
Dr. DR H●●. C●●●●●●●●●●I H●●●●●I Internal Medicine
If the PT is stable dengue leasion can be cleared by broad spectrum antibiotic & platelet supplementation & nerve regevination .
Nov 1, 2018Like