Neurological Manifestations of Perinatal Dengue

Mimickers of Hypoxic Ischemic Encephalopathy

Although neonatal encephalopathy is most often caused by hypoxic-ischemic injury, there are many other causes. A careful history and clinical examination allow clinicians to identify neonates with these mimickers, so prompt intervention and support ensue to allow the best developmental outcome.

Recurrent apnoea: a neurological manifestation of congenital dengue

Congenital dengue is seen in endemic areas during monsoon seasons. The clinical manifestations can vary from an asymptomatic newborn to mild symptoms like fever and rash to severe manifestations like shock and bleeding. The neurological manifestations of congenital dengue are uncommon compared with older children. The described symptoms/complications in the literature include congenital birth defects such as microcephaly, encephalitis and intraventricular haemorrhage. Apnoea as a manifestation of dengue has not yet been described in the literature. Here, we discuss a newborn baby with congenital dengue who had recurrent apnoea with positive NS1 antigen in cerebrospinal fluid.

Clinical case of co-infection: Dengue fever and respiratory mycoplasmosis in a child

According to WHO, dengue fever (DF) is currently endemic to more than 100 countries in various regions of Africa, America, and Asia; outbreaks have been reported in Europe. In the Russian Federation, there is a much smaller proportion of children among those infected due to the imported nature of the infection. We described a clinical case of imported dengue fever in an adolescent girl in Moscow after a 5-day vacation. Despite the fact that during the examination at the hospital in the Maldives, DENV arbovirus antigen was isolated in the blood by immunochromatographic rapid test, the course of the disease had a number of symptoms that did not conform to the classical course of the disease: catarrhal symptoms, cough, elevated C-reactive protein, and radiographic evidences of right-sided maxillary sinusitis. No improvement in the condition was observed despite the therapy administered. Additional examination confirmed an active infection caused by M. pneumoniae. After correction of etiotropic and pathogenetic therapy, the patient was discharged with recovery on day 10 of the disease. After 4 years since the start of the pandemic, an increase in infectious morbidity, particularly DF, has been observed. The proportion of co-infections is increasing. Co-infection of DF and respiratory mycoplasmosis in children may occur masked as an acute respiratory viral infection (ARVI): with intensification of catarrhal and intoxication syndromes and atypical changes in laboratory parameters. All that complicates clinical and laboratory diagnosis and leads to incorrect administration of starting etiotropic therapy.

Square the Circle: Diversity of Viral Pathogens Causing Neuro-Infectious Diseases

Neuroinfections rank among the top ten leading causes of child mortality globally, even in high-income countries. The crucial determinants for successful treatment lie in the timing and swiftness of diagnosis. Although viruses constitute the majority of infectious neuropathologies, diagnosing and treating viral neuroinfections remains challenging. Despite technological advancements, the etiology of the disease remains undetermined in over half of cases. The identification of the pathogen becomes more difficult when the infection is caused by atypical pathogens or multiple pathogens simultaneously. Furthermore, the modern surge in global passenger traffic has led to an increase in cases of infections caused by pathogens not endemic to local areas. This review aims to systematize and summarize information on neuroinvasive viral pathogens, encompassing their geographic distribution and transmission routes. Emphasis is placed on rare pathogens and cases involving atypical pathogens, aiming to offer a comprehensive and structured catalog of viral agents with neurovirulence potential.