Reader Response: Dengue and Chikungunya Infection in Neurologic Disorders From Endemic Areas in Brazil
KhicharShubhakaran, Senior Professor Neurology, MDM Hospital, Dr. S.N. Medical College, Jodhpur (Raj), India-342003
Submitted April 23, 2021
I read with interest the study by da Silva Mello et al.1 Dengue is frequently associated with various neurologic complications or sequelae. We encountered a patient of longitudinally extensive transverse myelitis (LETM)2 with Dengue virus infection in a cohort of approximately 70 patients with LETM. Similarly, in a study from an adjacent area, Dengue accounted for about 10% of patients in non-compressive myelopathy.3 Other neurologic complications are also being described from India like encephalitis, Guillain-Barré Syndrome (GBS), Acute Disseminated EncephaloMyelitis (ADEM), opsoclonus myoclonus, brachial neuritis, hyperkalemic paralysis, etc.4
In my experience, I have seen GBS in Dengue and Malaria co-infections. In many complications, the Dengue and Malaria are quite similar, but differ considerably in the treatment.5,6 Thus, Dengue infection should be suspected and evaluated in the endemic area with these acute neurologic illnesses while evaluating infectious and post-infectious causes in the endemic areas, and patients of Dengue need to be observed for these complications to give timely treatment. Furthermore, it helps in timely management of other Dengue complications like bleeding/hemorrhages, shock, etc.
Disclosure
The author reports no relevant disclosures. Contact journal@neurology.org for full disclosures.
References
Mello CDS, Cabral-Castro MJ, Silva de Faria LC, Peralta JM, Puccioni-Sohler M. Dengue and chikungunya infection in neurologic disorders from endemic areas in Brazil. Neurol Clin Pract. 2020;10(6):497-502. doi:10.1212/CPJ.0000000000000776
Shubhakaran K, Bhargava A, Nitti K K, Awasthi P, Modi D. Longitudinally Extensive Transverse Myelitis with Dengue Virus Infection. EC Neurology 2018;10.7:536-538.
Kamble S, Sardana V, Maheshwari D, Bhushan B, Ojha P. Etiological Spectrum of Non-compressive Myelopathies in Tertiary Care Centre. J Assoc Physicians India. 2019;67(9):14-16.
Verma R, Sharma P, Garg RK, Atam V, Singh MK, Mehrotra HS. Neurological complications of dengue fever: Experience from a tertiary center of north India. Ann Indian Acad Neurol. 2011;14(4):272-278. doi:10.4103/0972-2327.91946
Shubhakaran, Jakhar R. Ocular changes in infectious diseases. J Assoc Physicians India. 2005;53:913-914.
Mehta S. Ocular lesions in severe dengue hemorrhagic fever (DHF). J Assoc Physicians India. 2005;53:656-657.
I read with interest the study by da Silva Mello et al.1 Dengue is frequently associated with various neurologic complications or sequelae. We encountered a patient of longitudinally extensive transverse myelitis (LETM)2 with Dengue virus infection in a cohort of approximately 70 patients with LETM. Similarly, in a study from an adjacent area, Dengue accounted for about 10% of patients in non-compressive myelopathy.3 Other neurologic complications are also being described from India like encephalitis, Guillain-Barré Syndrome (GBS), Acute Disseminated EncephaloMyelitis (ADEM), opsoclonus myoclonus, brachial neuritis, hyperkalemic paralysis, etc.4
In my experience, I have seen GBS in Dengue and Malaria co-infections. In many complications, the Dengue and Malaria are quite similar, but differ considerably in the treatment.5,6 Thus, Dengue infection should be suspected and evaluated in the endemic area with these acute neurologic illnesses while evaluating infectious and post-infectious causes in the endemic areas, and patients of Dengue need to be observed for these complications to give timely treatment. Furthermore, it helps in timely management of other Dengue complications like bleeding/hemorrhages, shock, etc.
Disclosure
The author reports no relevant disclosures. Contact journal@neurology.org for full disclosures.
References