“Locked in a cage”—A case of dengue virus 4 encephalitis

• Main Authors: Ng, Deborah H. L., Sadarangani, Sapna P.
• Other Authors: Gérardin, Patrick
• Format: Article
• Language: English
• Published: 2018
• Subjects: Virus Encephalitis; Dengue; DRNTU::Science::Medicine
• Online Access: https://hdl.handle.net/10356/88391; http://hdl.handle.net/10220/45723
• Institution: Nanyang Technological University

Our patient with DENV-4 infection developed new acute neurological symptoms of confusion and expressive aphasia at day 6 of her acute dengue illness. CSF showed lymphocytic pleocytosis with a positive CSF dengue IgM and IgG. Testing for other pathogens in CSF was negative. She had not travelled to areas endemic for other flaviviruses. Although DENV-4 has been reported to potentially cause encephalitis, those cases were fatal, with multiorgan involvement and dengue haemorrhagic fever. [6,7] By contrast, our patient had no other features of severe dengue, such as severe plasma leakage, bleeding, or other organ impairment. This is the first known case of DENV-4 encephalitis with complete recovery.