Importance of cerebrospinal fluid investigation during dengue infection in Brazilian Amazonia Region
BACKGROUND Amazon, the largest tropical forest of the world, has suffered from dengue outbreaks since 1998. Cerebrospinal fluid (CSF) of patients, from Amazonas state, suspected of central nervous system (CNS) viral infection was studied using molecular and immunological methods. OBJECTIVE To evalua...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Fundação Oswaldo Cruz (FIOCRUZ)
2018-12-01
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| Series: | Memorias do Instituto Oswaldo Cruz |
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| Online Access: | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0074-02762019000100300&lng=en&tlng=en |
| _version_ | 1797718211030941696 |
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| author | Michele de Souza Bastos Valquiria do Carmo Alves Martins Natália Lessa da Silva Samya Jezine Sérgio Pinto Valderjane Aprigio Rossicleia Lins Monte Silvio Fragoso Marzia Puccioni-Sohler |
| author_facet | Michele de Souza Bastos Valquiria do Carmo Alves Martins Natália Lessa da Silva Samya Jezine Sérgio Pinto Valderjane Aprigio Rossicleia Lins Monte Silvio Fragoso Marzia Puccioni-Sohler |
| author_sort | Michele de Souza Bastos |
| collection | DOAJ |
| description | BACKGROUND Amazon, the largest tropical forest of the world, has suffered from dengue outbreaks since 1998. Cerebrospinal fluid (CSF) of patients, from Amazonas state, suspected of central nervous system (CNS) viral infection was studied using molecular and immunological methods. OBJECTIVE To evaluate the importance of CSF investigation in patients with acute dengue virus (DENV) infection of CNS. METHODS CSF samples of 700 patients were analysed by reverse transcription polymerase chain reaction (RT-PCR) to detect the presence of dengue virus (DENV) RNA and by enzyme-linked immunosorbent assay (ELISA) to detect presence of DENV specific IgM. FINDINGS DENV infection was detected in 4.3% of the CSF samples; 85.7% (24/28) by DENV IgM and 14.3% (4/28) by viral RNA. DENV detected by viral RNA were to be found serotypes DENV-2 (three patients) and DENV-1 (one patient). The neurological diagnosis in patients CNS infection of DENV included encephalitis (10), meningoencephalitis (10), meningitis (6), acute myelitis (1), and encephalomyelitis (1). The majority (89.3%) had intrathecal inflammation: pleocytosis, hyperproteinorrachia and DENV IgM antibodies. Hypoglycorrhachia and/or high levels of lactate in CSF were found in 36% of the patients. Co-infection (CMV, HIV, EBV, and/or Mycobacterium tuberculosis) was observed in eight (28.6%) cases. CONCLUSIONS We found intense inflammatory CSF that is unusual in CNS disorders caused by dengue infection. It may be due co-infections or the immunogenetic background of the local Amerindian Brazilian population. CSF examination is an important diagnostic support tool for neurological dengue diagnosis. |
| first_indexed | 2024-03-12T08:47:37Z |
| format | Article |
| id | doaj.art-3f43c893737c4b77a292a393874f448a |
| institution | Directory Open Access Journal |
| issn | 1678-8060 |
| language | English |
| last_indexed | 2024-03-12T08:47:37Z |
| publishDate | 2018-12-01 |
| publisher | Fundação Oswaldo Cruz (FIOCRUZ) |
| record_format | Article |
| series | Memorias do Instituto Oswaldo Cruz |
| spelling | doaj.art-3f43c893737c4b77a292a393874f448a2023-09-02T16:25:08ZengFundação Oswaldo Cruz (FIOCRUZ)Memorias do Instituto Oswaldo Cruz1678-80602018-12-01114010.1590/0074-02760180450S0074-02762019000100300Importance of cerebrospinal fluid investigation during dengue infection in Brazilian Amazonia RegionMichele de Souza BastosValquiria do Carmo Alves MartinsNatália Lessa da SilvaSamya JezineSérgio PintoValderjane AprigioRossicleia Lins MonteSilvio FragosoMarzia Puccioni-SohlerBACKGROUND Amazon, the largest tropical forest of the world, has suffered from dengue outbreaks since 1998. Cerebrospinal fluid (CSF) of patients, from Amazonas state, suspected of central nervous system (CNS) viral infection was studied using molecular and immunological methods. OBJECTIVE To evaluate the importance of CSF investigation in patients with acute dengue virus (DENV) infection of CNS. METHODS CSF samples of 700 patients were analysed by reverse transcription polymerase chain reaction (RT-PCR) to detect the presence of dengue virus (DENV) RNA and by enzyme-linked immunosorbent assay (ELISA) to detect presence of DENV specific IgM. FINDINGS DENV infection was detected in 4.3% of the CSF samples; 85.7% (24/28) by DENV IgM and 14.3% (4/28) by viral RNA. DENV detected by viral RNA were to be found serotypes DENV-2 (three patients) and DENV-1 (one patient). The neurological diagnosis in patients CNS infection of DENV included encephalitis (10), meningoencephalitis (10), meningitis (6), acute myelitis (1), and encephalomyelitis (1). The majority (89.3%) had intrathecal inflammation: pleocytosis, hyperproteinorrachia and DENV IgM antibodies. Hypoglycorrhachia and/or high levels of lactate in CSF were found in 36% of the patients. Co-infection (CMV, HIV, EBV, and/or Mycobacterium tuberculosis) was observed in eight (28.6%) cases. CONCLUSIONS We found intense inflammatory CSF that is unusual in CNS disorders caused by dengue infection. It may be due co-infections or the immunogenetic background of the local Amerindian Brazilian population. CSF examination is an important diagnostic support tool for neurological dengue diagnosis.http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0074-02762019000100300&lng=en&tlng=enflaviviruscerebrospinal fluiddengue virusimmunoglobulin IgMmeningitisencephalitis |
| spellingShingle | Michele de Souza Bastos Valquiria do Carmo Alves Martins Natália Lessa da Silva Samya Jezine Sérgio Pinto Valderjane Aprigio Rossicleia Lins Monte Silvio Fragoso Marzia Puccioni-Sohler Importance of cerebrospinal fluid investigation during dengue infection in Brazilian Amazonia Region Memorias do Instituto Oswaldo Cruz flavivirus cerebrospinal fluid dengue virus immunoglobulin IgM meningitis encephalitis |
| title | Importance of cerebrospinal fluid investigation during dengue infection in Brazilian Amazonia Region |
| title_full | Importance of cerebrospinal fluid investigation during dengue infection in Brazilian Amazonia Region |
| title_fullStr | Importance of cerebrospinal fluid investigation during dengue infection in Brazilian Amazonia Region |
| title_full_unstemmed | Importance of cerebrospinal fluid investigation during dengue infection in Brazilian Amazonia Region |
| title_short | Importance of cerebrospinal fluid investigation during dengue infection in Brazilian Amazonia Region |
| title_sort | importance of cerebrospinal fluid investigation during dengue infection in brazilian amazonia region |
| topic | flavivirus cerebrospinal fluid dengue virus immunoglobulin IgM meningitis encephalitis |
| url | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0074-02762019000100300&lng=en&tlng=en |
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