PDF(Pubmed)
Abstract：
BACKGROUND: Dengue is an important public health problem, which caused by the dengue virus (DENV), a single-stranded RNA virus consisted of four serotypes. Central nervus system (CNS) impairment in dengue usually results from DENV-2 or DENV-3 infection, which lead to life-threatening outcomes. Furthermore, neurological complications due to DENV-1 was rare especially in adult patients.
METHODS: A 44-year-old man without comorbidities had lethargy after hyperpyrexia and a positive DENV NS1 antigen was detected for confirming the diagnosis of dengue on day 8 of onset. Then logagnosia, decreased muscle strength, delirium and irritability were occurred even radiographic examination were normal. He was treated with low-dose hormone, sedatives and gamma goblin with a short duration of 6 days. The cerebrospinal fluid (CSF) tests were persistent normal. However, presence of DENV-1 RNA was confirmed both in CSF and serum. Furthermore, the complete sequence of the DENV isolated from the patient\'s serum was performed (GenBank No.: MW261838). The cytokines as IL-6, IL-10 and sVCAM-1 were increased in critical phase of disease. Finally, the patient was discharged on day 24 of onset without any neurological sequelae.
CONCLUSIONS: Encephalopathy caused by a direct CNS invasion due to DENV-1 during viremia was described in an adult patient. Treatment with low-dose hormone and gamma goblin was helpful for admission.
METHODS: A 44-year-old man without comorbidities had lethargy after hyperpyrexia and a positive DENV NS1 antigen was detected for confirming the diagnosis of dengue on day 8 of onset. Then logagnosia, decreased muscle strength, delirium and irritability were occurred even radiographic examination were normal. He was treated with low-dose hormone, sedatives and gamma goblin with a short duration of 6 days. The cerebrospinal fluid (CSF) tests were persistent normal. However, presence of DENV-1 RNA was confirmed both in CSF and serum. Furthermore, the complete sequence of the DENV isolated from the patient\'s serum was performed (GenBank No.: MW261838). The cytokines as IL-6, IL-10 and sVCAM-1 were increased in critical phase of disease. Finally, the patient was discharged on day 24 of onset without any neurological sequelae.
CONCLUSIONS: Encephalopathy caused by a direct CNS invasion due to DENV-1 during viremia was described in an adult patient. Treatment with low-dose hormone and gamma goblin was helpful for admission.
摘要：
背景：登革热是一个重要的公共卫生问题，由登革热病毒（DENV）引起的，单链RNA病毒由四种血清型组成.登革热中枢神经系统（CNS）损伤通常由DENV-2或DENV-3感染引起，导致危及生命的结果。此外，DENV-1引起的神经系统并发症很少见,尤其是在成年患者中.
方法：一名没有合并症的44岁男性高热后嗜睡，在发病第8天检测到阳性DENVNS1抗原以确认登革热的诊断。然后是logagnosia,肌肉力量下降，即使影像学检查正常，也会发生谵妄和易怒。他接受了低剂量激素治疗,镇静剂和伽玛妖精，持续时间短6天。脑脊液（CSF）测试持续正常。然而,在CSF和血清中均证实了DENV-1RNA的存在。此外，从患者血清中分离出的DENV的完整序列(GenBankNo.：MW261838）。在疾病的关键阶段，细胞因子如IL-6，IL-10和sVCAM-1增加。最后,患者在发病第24天出院，无任何神经系统后遗症。
结论：在一名成年患者中描述了由病毒血症期间DENV-1引起的直接中枢神经系统侵袭引起的脑病。低剂量激素和伽玛妖精治疗有助于入院。
方法：一名没有合并症的44岁男性高热后嗜睡，在发病第8天检测到阳性DENVNS1抗原以确认登革热的诊断。然后是logagnosia,肌肉力量下降，即使影像学检查正常，也会发生谵妄和易怒。他接受了低剂量激素治疗,镇静剂和伽玛妖精，持续时间短6天。脑脊液（CSF）测试持续正常。然而,在CSF和血清中均证实了DENV-1RNA的存在。此外，从患者血清中分离出的DENV的完整序列(GenBankNo.：MW261838）。在疾病的关键阶段，细胞因子如IL-6，IL-10和sVCAM-1增加。最后,患者在发病第24天出院，无任何神经系统后遗症。
结论：在一名成年患者中描述了由病毒血症期间DENV-1引起的直接中枢神经系统侵袭引起的脑病。低剂量激素和伽玛妖精治疗有助于入院。
