■登革热神经感染可表现为轻度至重度的症状。典型的介绍,比如扩大型登革热综合征,提出诊断和治疗挑战。神经影像学发现,特别是大脑磁共振成像(MRI)上的“双圈”标志,已成为诊断登革热病毒感染中枢神经系统复杂病例的最有价值的辅助手段之一。
■我们报告了一名来自西孟加拉邦农村的35岁女性病例,印度,患有扩大的登革热综合征。病人出现发烧,头痛,身体疼痛,几分钟后突然迷失方向,进展为昏迷.神经系统检查显示出严重的无意识和颈部僵硬。实验室检查结果与登革热感染一致,包括改变肝脏和胰酶水平。通过识别脑部MRI上的“双甜甜圈”标志来促进诊断,提示登革热脑炎.这一发现以及临床和血清学证据指导了治疗策略。
■“双甜甜圈”标志,虽然不是登革热脑炎独有的,在这种情况下被证明是至关重要的,有助于区分脑炎的其他原因。对这一体征的识别对于诊断扩大型登革热综合征至关重要,促进及时和适当的干预,改善患者预后。此病例也强调了在脑炎的鉴别诊断中考虑登革热的重要性,尤其是在流行地区。此外,该病例的出色结局(临床和放射学)值得注意。
UNASSIGNED: Dengue neuro-infection can present with symptoms ranging from mild to severe. Atypical presentations, such as expanded dengue syndrome, pose diagnostic and therapeutic challenges. Neuroimaging findings, particularly the \"double-doughnut\" sign on brain magnetic resonance imaging (MRI), have emerged as one of the most valuable aids in diagnosing complex cases of central nervous system infection by dengue virus.
UNASSIGNED: We report the
case of a 35-year-old female from rural West Bengal, India, with expanded dengue syndrome. The patient presented with fever, headaches, body aches, and sudden disorientation over minutes, which progressed to a coma. Neurological examination revealed profound unconsciousness and nuchal rigidity. Laboratory findings were consistent with dengue infection, including altered liver and pancreatic enzyme levels. The diagnosis was facilitated by identifying the \"double-doughnut\" sign on the brain MRI, which suggested dengue encephalitis. This finding and clinical and serological evidence guided the treatment strategy.
UNASSIGNED: The \"double-doughnut\" sign, though not exclusive to dengue encephalitis, proved crucial in this
case, aiding in differentiating from other causes of encephalitis. Recognition of this sign can be pivotal in diagnosing expanded dengue syndrome, facilitating timely and appropriate intervention, and improving patient outcomes. This
case also underscores the importance of considering dengue in the differential diagnosis of encephalitis, especially in endemic areas. Also, this
case\'s excellent outcome (both clinically and radiologically) was noteworthy.