Central Nervous System Involvement in Dengue Virus Type 1 Infection: A Pediatric Case Series

Central nervous system involvement accounted for 0.5 to 21.2% of dengue virus infections. Dengue virus type 2 and type 3 were commonly found in patients with central nervous system manifestations, while dengue virus type 1 (DENV-1) was rarely reported. We reported three dengue fever cases with neurological complications associated with DENV-1 infection. A previously healthy boy presented with fever, agitation, and an altered mental status in the first case. The other two cases presented with fever and seizures. All of them had no plasma leakage from dengue infection. DENV-1 was detected by reverse transcriptase-polymerase chain reaction assay in cerebrospinal fluid, serum, or both. All three cases were resolved entirely without neurological sequelae. This study can alert hospitals to prepare for the next epidemic in which there could be increasing cases of unusual or severe manifestations of dengue.