CASE 91 – by Dr Devarati Khurjekar, Jahangir Hospital, Pune
9 Year old female with history of fever, and tonic-clonic convulsions
MRI of brain performed.
Select option
A - Viral encephalitis
B - Japanese encephalitis( other flavi viruses)
C - Herpes simplex encephalitis
D - Dengue Encephalitis
click for answer
FINDINGS & DISCUSSION
Symmetrical hyperintense signal within medulla, pons, cerebellar peduncles, periaqueductal grey matter, bilateral thalami, crus cerebri, periventricular white matter on FLAIR and T2
Iso to hypointense on T1
Showing restricted diffusion
Central blooming on GRE
Liver function Tests - deranged.
CSF
Protein- 297
Sugar – 56
Cell count- 15
Dengue NS1 positive
DISCUSSION
Dengue encephalopathy is usually secondary to multisystem derangement like shock, hepatitis, coagulopathy, and concurrent bacterial infection
Incidence ranges from 0.5 to 6.2 %
Dengue encephalitis is a different entity, which occurs due to direct neuronal infiltration by the dengue virus.