The Spectrum of Neurological Complications in Dengue: The Neuroinfections Emerging in the Americas Study (NEAS) in Colombia
Ana Villegas1, Mariana Medina2, David Acero3, Catalina Vallejo4, Thanya Lagos5, Federico Silva6, Melissa Gomez7, Katherine Claros8, Susana Dominguez-Peñuela3, Martha Moyano9, Lyda Osorio10, Beatriz Parra11, Carlos Pardo-Villamizar12, Guillermo Gonzalez13, Maria Reyes-Mantilla14
1Neurology, Universidad del Bosque, 2Neurology, 1.Department of Neurology, Hospital Simón Bolívar, E.S.E. Subred Integrada de Servicios de Salud Norte, Bogotá, Colombia, 3Neurology, Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, 4Neurology, Hospital Universitario Departamental Narino, 5Neurology, Universidad del Valle, 6Fundacion Cardiovascular De Colombia, 7Neurology, Fundacion Cardiovascular de Colombia, Bucaramanga, Colombia, 8Neurology, Hospital Universitario Hernando Moncaleano Perdomo, Neiva, Colombia, 9Proyectos Clinicos, 3.Universidad del Valle, Cali, Colombia, 10Escuela de Salud Publica, 11Escuela de Ciencias Basicas, Universidad del Valle, Cali, Colombia, 12Johns Hopkins U, Med Dept of Neurology, 13Neurology, Universidad Surcolombiana,Hospital Universitario Hernando Moncaleano Perdomo, Neiva,Huila., 14Johns Hopkins University, Neurology
Objective:
To characterize the demographic, clinical, and laboratory features of neurological complications of dengue virus (DENV) enrolled in the NEAS cohort.
Background:
The global incidence of neurological complications of DENV varies between 5% and 21%. In Colombia, the last epidemic outbreak of DENV started in 2023, with all four serotypes circulating. Neurological manifestations could be classified as direct (e.g., encephalitis), indirect (e.g., encephalopathy), or post-infectious complications (e.g., myelitis, Guillain-Barré syndrome [GBS]).
Design/Methods:
In a multicenter, observational, and prospective study to investigate acute neuroinflammatory disorders based in eight Colombian cities, blood, urine, and CSF samples were used to investigate arboviral infections, including DENV infection.
Results:
Nine patients were diagnosed with neurological complications of dengue, with most of the diagnoses done in 2024, except for one patient. The majority (78%, n=7) presented with encephalopathy or encephalitis, while two patients (22%) were diagnosed with GBS. The median age was 41 years (IQR:25-63) and 67% (n=6) were male. Laboratory blood testing showed positive serum DENV-IgM in 6 (75%) , serum DENV-IgG in 5 (63%), NS1 antigen in 3 (25%), and DENV serotype 1 by RT- PCR in blood of 2 patients (22%). CSF findings included a median cell count of 0 (range 0-9), glucose of 65 mg/dL (range 53-77), and proteins of 42 mg/dL (range 23-64). Neuroimaging was abnormal in only one case. In two GBS patients, neurophysiological studies showed a case of axonal motor neuropathy (AMAN) and one case of demyelinating polyneuropathy (AIDP). ICU admission was required in 88% (n=7) of the cases, with 3 (43%) needing ventilatory support. Mortality was reported in one case.
Conclusions:
Although dengue's neurological problems are rare and emerging in severe dengue settings, most cases require ICU admission. In our cohort, neurological complications of DENV infection were mainly associated with encephalopathy, with normal CSF and neuroimaging findings.
Disclaimer: Abstracts were not reviewed by Neurology® and do not reflect the views of Neurology® editors or staff.