Dengue fever presenting with cerebellitis: A case report

Abstract

Rationale: Dengue fever is a mosquito-bome viral infection, which commonly presents as an acute febrile illness. As the number of cases increases, rare manifestations including neurological manifestations are occasionally encountered.

Patient concerns: A 20-year-old female presented with fever for 3 days with slurring of speech and unsteady gait, which were developed from the third day of illness. On examination, she had bilateral cerebellar signs. Dengue non-structural protein 1 antigen and dengue IgM in serum were positive. Her cerebrospinal fluid analysis and magnetic resonance image brain were normal.

Diagnosis： Dengue cerebellitis.

Intervention： Supportive management with fluids including oral rehydration solutions and intravenous fluids and paracetamol.

Outcome： Cerebellar symptoms and signs completely resolved by the 20th day of illness.

Lesson： Dengue cerebellitis is an unusual neurological manifestation of dengue infection.

Keywords

Dengue fever / Cerebellitis / Neurological manifestations

Conflict of interest statement

The authors declare that they have no conflict of interest.

Funding

The authors received no extramural funding for the study.

Ethical approval and patient’s consent

Written informed consent for patient information and images to be published was provided by the patient.

Authors’ contributions

SS developed the theoretical formalism, performed the analytic calculations and performed the numerical simulations. SS and LFS contributed to the final version of the manuscript. PR edited and proof checked the manuscript. DA and PJ supervised the project.

Publisher’s note

The Publisher of the Journal remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

References

[1] Sahu MC, Samantaray RK, Pal A, Pati S. Recent advances on pathogenesis, diagnosis, prevention, immunological aspects, and vectors of dengue: A review. Asian Pac J Trop Biomed 2023; 13(8): 325-338.

[2] Hasan M, Islam S. Epidemiology and evolution of dengue outbreaks in Bangladesh(2020-2023). One Health Bull 2024; 4(2): 60-68.

[3] Epidemiology Unit of Sri Lanka. Dengue in Sri Lanka. [Online]. Available from: http://www.epid.gov.lk/web/index.php?option=com_casesanddeaths&. [Accessed on 20 April 2024].

[4] Carod-Artal FJ, Wichmann O, Farrar J, Gascón J. Neurological complications of dengue virus infection. Lancet Neurol 2013; 12(9): 906-919.

[5] Khoo CS. Dengue cerebellitis: A case report and literature review. Am J Case Rep 2018; 19: 864-867.

[6] Rajapakse S, Rodrigo C, Rajapakse A: Treatment of dengue fever. Infect Drug Resist 2012; 5: 103-112.

[7] Nimmagadda SS, Mahabala C, Boloor A, Raghuram PM, Nayak UA. Atypical manifestations of dengue fever-Where do we stand today? J Clin Diagn Res 2014; 8(1): 71-73.

[8] Weeratunga PN, Caldera HP, Gooneratne IK, Gamage R, Perera WS, Ranasinghe GV, et al. Spontaneously resolving cerebellar syndrome as a sequelae of dengue viral infection: A case series from Sri Lanka. Pract Neurol 2014; 14(3): 176-178.

[9] Withana M, Rodrigo C, Chang T, Karunanayake P, Rajapakse S. Dengue fever presenting with acute cerebellitis: A case report. BMC Res Notes 2014; 7: 125.

[10] Jain VK, Rafey K, Afreen K, Jain A, Kohli S, Bhushan R. Dengue fever presenting with acute cerebellitis in an adult. IJMSCR 2020; 3(3): 251-258.

[11] Karunarathne S, Udayakumara Y, Fernando H. Epstein-Barr virus co-infection in a patient with dengue fever presenting with postinfectious cerebellitis: A case report. J Med Case Rep 2012; 6: 43.