AI Article Synopsis

  • * Key to her diagnosis was the identification of the "double-doughnut" sign on MRI, which indicated dengue encephalitis and helped differentiate it from other encephalitis causes.
  • * The case emphasizes the importance of recognizing atypical dengue presentations, particularly in areas where the virus is endemic, to ensure timely treatment and improve patient outcomes.

Article Abstract

Background: Dengue neuro-infection can present with symptoms ranging from mild to severe. Atypical presentations, such as expanded dengue syndrome, pose diagnostic and therapeutic challenges. Neuroimaging findings, particularly the "double-doughnut" sign on brain magnetic resonance imaging (MRI), have emerged as one of the most valuable aids in diagnosing complex cases of central nervous system infection by dengue virus.

Case Presentation: We report the case of a 35-year-old female from rural West Bengal, India, with expanded dengue syndrome. The patient presented with fever, headaches, body aches, and sudden disorientation over minutes, which progressed to a coma. Neurological examination revealed profound unconsciousness and nuchal rigidity. Laboratory findings were consistent with dengue infection, including altered liver and pancreatic enzyme levels. The diagnosis was facilitated by identifying the "double-doughnut" sign on the brain MRI, which suggested dengue encephalitis. This finding and clinical and serological evidence guided the treatment strategy.

Discussion: The "double-doughnut" sign, though not exclusive to dengue encephalitis, proved crucial in this case, aiding in differentiating from other causes of encephalitis. Recognition of this sign can be pivotal in diagnosing expanded dengue syndrome, facilitating timely and appropriate intervention, and improving patient outcomes. This case also underscores the importance of considering dengue in the differential diagnosis of encephalitis, especially in endemic areas. Also, this case's excellent outcome (both clinically and radiologically) was noteworthy.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC11181972PMC
http://dx.doi.org/10.1177/19418744241230730DOI Listing

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