Dados do Trabalho

Título

MYELITIS POST DENGUE

RESUMO

PRESENTATION OF THE CASE: A male, 32-year-old patient was admitted to the service due to a history of tetra paresthesia initiated three days before, progressing with lower limb paresis and urinary retention and inability to walk. Patients denied symptoms such as fever, itching or myalgia. He had no other comorbidities or continued medication. At the patient’s examination, she presented a preserved level of consciousness, hypoesthesia at L4 level and dysesthesia at T5 level and bilateral paresis of the lower limbs. In initial laboratory tests presented plaquetopenia, rapid test for Dengue positive, Liquor initially had leukocytes 99, lymphocytes 89, neutrophils 11, glucose 83 and proteins 118.3, lactate 3.3 and the absence of oligoclonal bands, anti-MOG and anti-aquaporin 4. No changes to initial skull tomography. Then, a column resonance was requested, which evidenced a C6-C7 signal alteration and in the entire dorsal column. MRI of the skull and orbits without alteration. Then initiated pulse therapy with methylprednisolone 1g for 5 days, the patient presented gradual improvement of symptoms, with improvement of sensitivity and strength of lower limbs. DISCUSSION: Transverse myelitis is a clinical picture of loss of strength, autonomic and sensory dysfunction, and its relation to dengue is rare. Neurological manifestations resulting from dengue, are atypical, compared to other arboviruses, and within these manifestations are the most frequent encephalitis and Guillain Barré syndrome. The diagnosis is based on the patient’s clinical, resonance exams and liquid analysis, and the presentation of the condition can appear about 4 days after classic symptoms of dengue, such as fever and myalgia. In this specific case, the patient did not present classic symptoms resulting from dengue, and the neurological condition was the only manifestation of the disease. The treatment proposed in the literature is pulse therapy with methylprednisolone for 5 days, which was performed in the case with adequate response to medication. FINAL COMMENTS: Post-dengue myelitis is one of the rare neurological manifestations of this arbovirus, with a small sample described in the literature, and it is important to report these cases to better understand the pathological mechanisms related to dengue.

Palavras Chave

Dengue, Mielites Transversa, Arboviroses