NEUROLOGICAL MANIFESTATIONS OF DENGUE FEVER

Abstract

Objective: To observe the pattern of neurological complications in hospitalized cases of dengue fever (DF) and study the association of various clinical parameters with neurological manifestations of DF.

Study Design: A cross-sectional descriptive study.

Place and Duration of Study: CMH Lahore, from August 2011 to November 2011.

Patients and Methods: The study was based on clinical profile and outcome of 640 adult hospitalized patients of DF. They were categorized on the basis of neurological involvement into DF, with and without neurological manifestations. After clinical evaluation, blood samples were taken for a complete blood count, urea, creatinine, sodium, potassium, bilirubin, alanine transaminase (ALT), prothrombin time (PT) and activated partial thromboplastin time (APTT). SPSS 18 was used for statistical analysis of clinical data.

Results: Thirty eight out of 640 hospitalized DF patients had significant neurological involvement. The age of the patients ranged from 13 to 84 years with an average of 44.5 ± 19.2 years in DF cases with neurological manifestations and 38.0 ± 14.1 years in DF cases without neurological manifestations. Most of the cases with neurological involvement fulfilled the World Health Organization (WHO) criteria for dengue haemorrhagic fever (62.4%). Systolic and diastolic blood pressures were significantly low, platelet counts were also very low and serum ALT levels significantly high in DF patients with neurological involvement. Case fatality rate was 26.3% in DF cases with neurological involvement as compared to 1.6% in the rest of the DF patients without neurological involvement (p<0.001).

Conclusion: Recognition of dengue infection as causative agent in patients presenting with neurological complications is important in endemic areas to avoid potentially toxic and costly treatments.