期刊
PATHOGENS AND GLOBAL HEALTH
卷 115, 期 7-8, 页码 476-482出版社
TAYLOR & FRANCIS LTD
DOI: 10.1080/20477724.2021.1942680
关键词
Dengue virus; encephalitis; meningitis; myelitis; neurologic complication; children
资金
- Conselho Nacional de Desenvolvimento Cientifico e Tecnologico [CNPq -440911/2015, 2058/2016]
- Departamento de Ciencia e Tecnologia do Ministerio da Saude do Brasil (DECIT) Coordenacao de Aperfeicoamento de Pessoal de Nivel Superior (CAPES) [001]
- Fundacao de Amparo a Pesquisa do Estado de Minas Gerais (FAPEMIG)
In a study conducted in Brazil, 39% of children with dengue virus infections were found to have neurological complications after hospital discharge, with an average resolution time of 5.9 months. These results highlight the challenges in diagnosing and managing neurological complications in children after discharge, and the importance of early intervention through RT-qPCR etiological diagnosis.
The aim was to assess neurological complications in children with an invasive neurological disease by dengue virus (DENV) and the time to resolve symptoms after hospital discharge. A prospective study was conducted at a referral hospital for infectious diseases in Brazil between March 2014 and July 2019. All children hospitalized with neurologic manifestations and DENV RNA detected by real-time reverse transcription-polymerase chain reaction (RT-qPCR) in cerebrospinal fluid (CSF) were followed up until complete resolution of neurological complications. On average, they were followed up for 16 months. Among 56 DENV-positive children, 39% had some neurologic complications after hospital discharge and found that 19.6% were discharged with anticonvulsants due to seizures, 10.7% developed motor complications (e.g. muscle weakness, paresis, ataxia, and walking disability), 5.4% had headaches, and 14.3% had sleep disorders. Among the 56 children, only three had a clinical diagnosis of dengue because the symptoms are nonspecific and 35% showed no change in cerebrospinal fluid (CSF). The average time to resolve complications was 5.9 months (ranging from 1 m to 32 m). These results should alert physicians to the difficulties of a clinical diagnosis of an infection that causes neurological complications after discharge in a significant number of children. RT-qPCR's etiological diagnosis of DENV infection enabled better clinical follow-up for early intervention in children with neurological complications.
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