Dengue Encephalitis and Encephalopathy are Different Entity - Case Study

Dengue encephalitis is a different entity, which possibly occurs due to direct neuronal infiltration by the dengue virus. Encephalopathy is a rare though well-known neurological complication of dengue infection. These two different cases, therefore, highlight the lack of a definite scientific explanation of the exact pathogenesis behind neurological syndromes in dengue infection with minimum clinical signs. A 23-year-old female patient (Case 1) was admitted with a history of fever, headache and joints pain for the 4 days, followed by two episodes of seizures on the fourth day of illness and subsequently developed altered sensorium. Her both dengue IgM and IgG dengue antibodies were positive. Her lumbar puncture revealed that evidence of lymphocytic pleocytosis with normal protein and sugar. She has been diagnosed with encephalitis. A 31-year-old gentleman (Case 2) was admitted with the history of fever, myalgia, arthralgia, and headache for five days duration. His blood test confirmed that both IgM and IgG antibodies were positive. In Cerebrospinal fluid (CSF) analysis revealed that protein and sugar were normal and no evidence of pleocytosis. He was diagnosed with dengue fever complicated with encephalopathy. The pathophysiology of dengue encephalitis and encephalopathy are a benign but potentially fatal disease. However, encephalitis must always be distinguished from an encephalopathy, which may present similar manner. It is vital for developing a more effective management plan.