Importance of cerebrospinal fluid investigation during dengue infection in Brazilian Amazonia Region
Mem. Inst. Oswaldo Cruz
;
114: e180450, 2019. tab, graf
Article
in English
| LILACS
| ID: biblio-976243
ABSTRACT
BACKGROUND Amazon, the largest tropical forest of the world, has suffered from dengue outbreaks since 1998. Cerebrospinal fluid (CSF) of patients, from Amazonas state, suspected of central nervous system (CNS) viral infection was studied using molecular and immunological methods. OBJECTIVE To evaluate the importance of CSF investigation in patients with acute dengue virus (DENV) infection of CNS. METHODS CSF samples of 700 patients were analysed by reverse transcription polymerase chain reaction (RT-PCR) to detect the presence of dengue virus (DENV) RNA and by enzyme-linked immunosorbent assay (ELISA) to detect presence of DENV specific IgM. FINDINGS DENV infection was detected in 4.3% of the CSF samples; 85.7% (24/28) by DENV IgM and 14.3% (4/28) by viral RNA. DENV detected by viral RNA were to be found serotypes DENV-2 (three patients) and DENV-1 (one patient). The neurological diagnosis in patients CNS infection of DENV included encephalitis (10), meningoencephalitis (10), meningitis (6), acute myelitis (1), and encephalomyelitis (1). The majority (89.3%) had intrathecal inflammation pleocytosis, hyperproteinorrachia and DENV IgM antibodies. Hypoglycorrhachia and/or high levels of lactate in CSF were found in 36% of the patients. Co-infection (CMV, HIV, EBV, and/or Mycobacterium tuberculosis) was observed in eight (28.6%) cases. CONCLUSIONS We found intense inflammatory CSF that is unusual in CNS disorders caused by dengue infection. It may be due co-infections or the immunogenetic background of the local Amerindian Brazilian population. CSF examination is an important diagnostic support tool for neurological dengue diagnosis.
Full text:
Available
Index:
LILACS (Americas)
Main subject:
Cerebrospinal Fluid
/
Flavivirus Infections
/
Meningitis
Limits:
Humans
Country/Region as subject:
South America
/
Brazil
Language:
English
Journal:
Mem. Inst. Oswaldo Cruz
Journal subject:
Tropical Medicine
/
Parasitology
Year:
2019
Type:
Article
Affiliation country:
Brazil
Institution/Affiliation country:
Fundação Centro de Controle de Oncologia do Estado do Amazonas/BR
/
Fundação de Medicina Tropical Dr Heitor Vieira Dourado/BR
/
Universidade Federal do Estado do Rio de Janeiro/BR
Similar
MEDLINE
...
LILACS
LIS