ABSTRACT
Chikungunya virus causes fever and severe polyarthritis or arthralgia and is associated with neurologic manifestations that are sometimes challenging to diagnose. We demonstrate intrathecal synthesis of chikungunya antibodies in a patient with a history of acute infection complicated by encephalitis. The specificity of the intracerebral immune response supports early chikungunya-associated encephalitis diagnosis.
Subject(s)
Chikungunya Fever/cerebrospinal fluid , Chikungunya Fever/diagnosis , Immunoglobulins/cerebrospinal fluid , Aged , Anti-Inflammatory Agents/therapeutic use , Biomarkers/cerebrospinal fluid , Chikungunya Fever/drug therapy , Cyclooxygenase Inhibitors/therapeutic use , Encephalitis, Viral , Female , Humans , Prednisolone/therapeutic use , Sulfonamides/therapeutic useABSTRACT
Dengue virus (DENV) causes immune-mediated diseases. Neurological involvement represents a severe condition that is rarely observed in DENV-1 infection. Neuromyelitis optica (NMO)/NMO spectrum disorders (NMOSD) are idiopathic immune-mediated demyelinating syndromes of the central nervous system. We report a 17-year-old female with oligosymptomatic DENV-1 viremia, diagnosed as NMOSD. Magnetic resonance imaging showed spinal cord and brainstem lesions. Antibody for aquaporin 4 was negative. DENV-1 RNA infection was detected by serial RT-PCR and confirmed by phylogenetic analysis in serum. Although there are some reports of NMO post-dengue infection, there are not any published accounts of NMOSD with coexistent and persistent DENV-1 infection.
