Was it a case of acute disseminated encephalomyelitis? A rare association following dengue fever

Abstract

Dengue infection, caused by a flavivirus is endemic in more than hundred countries, mostly in the developing world. Recent observations indicate that the clinical profile of dengue is changing, and that atypical manifestations are being reported more frequently. The exact incidence of various neurological complications is variable. Acute disseminated encephalomyelitis (ADEM) is a neurological manifestation rarely described in association with dengue. We present a patient, 32-year-old female who was diagnosed as a case of dengue fever initially after an acute febrile illness and two weeks later admitted in emergency with seizures and altered sensorium. Although MRI did not show typical lesions suggestive of ADEM, the lag period between initial dengue infection and neurological manifestations and complete recovery with methyl prednisolone point towards immune mediated demyelinating illness.