Dengue encephalitis: clinical manifestations and molecular pathogenesis
Keywords:dengue encephalitis, clinical manifestation, DENV, dengue virus, encephalitis
Background: Dengue encephalitis is an inflammation of the brain parenchyma that occurs due to direct neuronal infiltration by the dengue virus. It is estimated that 50 million dengue infections occur annually and about 2.5 billion people live in dengue endemic countries. When dengue infection is endemic in Brazil, dengue encephalitis is the highest cause of viral encephalitis and also causes meningitis in 10% of cases, in Indonesia is not yet available.
Objective: To know the clinical manifestations and molecular pathogenesis of dengue encephalitis.
Discussion: Neurological manifestations due to the dengue virus are related to differences in viral serotypes that occur in secondary infections with antibodies formed. Dengue virus or DENV will be neutralized by antibodies and immune protection is formed, but when the second infection happens with a different serotype, DENV cannot be neutralized by antibodies which then activate phagocytic cells such as monocytes and carry out viral replication, causing dengue hemorrhagic fever, dengue shock syndrome including neurologic manifestations.
Conclusion: The dengue virus can reach the brain hematogenously. The clinical manifestations of dengue encephalitis are fever, headache, loss of consciousness, meningismus seizures, positive plantar pedis extension pathological reflex, positive signs of frontal lobe symptoms, abnormal posture, cranial nerve paresis, and tetraparesis.
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