Hydrocephalus secondary to dengue encephalitis in an infant: case report
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CASE REPORT
Hydrocephalus secondary to dengue encephalitis in an infant: case report Bárbara Albuquerque Morais 1
&
Nayara Matos Pereira 1,2 & Cilmária Leite Franco 1 & Paulo Ronaldo Jubé Ribeiro 1,2,3
Received: 11 June 2020 / Accepted: 31 August 2020 # Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Background Dengue is the leading cause of mosquito-borne viral infection. It is responsible for high morbidity and mortality in children living in endemic areas. Nowadays, neurological complications are progressively referred to and include a broad spectrum of symptoms. It can be secondary to metabolic alterations, direct invasion by the virus, and enhanced autoimmune response. Case presentation Here, we report a rare case of hydrocephalus secondary to dengue encephalitis. A 13-day-old boy was diagnosed with dengue. He evolved with seizures and impaired consciousness being diagnosed with encephalitis. After clinical treatment, he was discharged fully recovered. Three months later, he presented with signs and symptoms of intracranial hypertension. Brain MRI revealed hydrocephalus secondary to acquired aqueduct stenosis. The patient underwent an endoscopic third ventriculocisternostomy. Conclusion Dengue infection is a differential diagnosis for acute febrile neurological impairment in children from endemic areas. Follow-up should be offered after dengue encephalitis to detect possible late-onset complications, as hydrocephalus. Keywords Hydrocephalus . Dengue infection . Encephalitis . Third ventriculostomy . Flavivirus . Dengue
Introduction Dengue is currently the leading cause of mosquito-borne viral infection [1, 2]. Over recent years, the global incidence has progressively increased, becoming endemic in various tropical and subtropical regions [1–4]. The annual incidence of dengue infection is estimated at 50 to 200 million cases, with a mortality rate of over 20,000 patients [1–3]. Factors such as virus properties, host immunity, and age can influence the severity of this disease. Dengue can affect all ages, including children; moreover, studies have shown a higher frequency of severe infection below the age of 9 years old [5].
* Bárbara Albuquerque Morais [email protected] 1
Department of Neurological Surgery, Children’s Hospital, Goiânia, Brazil
2
Department of Neurological Surgery, Hospital Estadual Alberto Rassi, Goiânia, Brazil
3
Department of Neurological Surgery, Hospital das Clinicas, School of Medicine, Federal University of Goiás Goiânia, Goiânia, Brazil
Is has been well documented that dengue can manifest with a broad scope of neurological symptoms [3, 5–10]. Thus, in the World Health Organization (WHO) last guideline, the central nervous system (CNS) involvement was recognized as one of the criteria for severe dengue diagnosis [4]. The incidence of these symptoms ranges from 0.5 to 21% of patients hospitalized with dengue [3, 6, 11–13]. It may be that this variation occurs due to the multifactorial origin of neurological impairment. According to Carod-Artal et al. [6
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