Arboviral Infections in Neurological Disorders in Hospitalized Patients in São José do Rio Preto, São Paulo, Brazil

Abstract

Arbovirus infections are increasingly important causes of disease, whose spectrum of neurological manifestations are not fully known. This study sought to retrospectively assess the incidence of arboviruses in cerebrospinal fluid samples of patients with neurological symptoms to inform diagnosis of central and peripheral nervous system disorders. A total of 255 cerebrospinal fluid (CSF) samples collected from January 2016 to December 2017 were tested for dengue virus (DENV 1-4), Zika virus (ZIKV), and Chikungunya virus (CHIKV) in addition to other neurotropic arboviruses of interest, using genetic and serologic assays. Of the 255 CSF samples analyzed, 3.53% (09/255) were positive for arboviruses presenting mainly as meningitis, encephalitis, and cerebrovascular events, of which ZIKV was detected in 2.74% (7/255), DENV in 0.78% (2/255), in addition to an identified ILHV infection that was described previously. All the cases were detected in adults aged 18 to 74 years old. Our findings highlight the scientific and clinical importance of neurological syndromes associated with arboviruses and demonstrate the relevance of specific laboratory methods to achieve accurate diagnoses as well as highlight the true dimension of these diseases to ultimately improve public health planning and medical case management.

Pooled Cohort Profile: ReCoDID Consortium’s Harmonized Acute Febrile Illness Arbovirus Meta-Cohort

“…Retrospective harmonization is generally resource-intensive (29,30), as we can attest to. In order to facilitate future IPD-MAs, we are in the process of creating a Case Report Form which we then standardized according to the CDISC data standard.…”

Encefalitis aguda por dengue durante el embarazo

“…Generalmente, el cuadro neurológico aparece temprano en el curso de la infección (incluso en el primer día de la enfermedad) y coincide con la fase virémica, aunque en la mayoría de los casos aparece entre 2 y 30 días después de la aparición del cuadro febril (10) . Otras manifestaciones neurológicas, como déficit motor, pueden ocurrir en la infección aguda (mielitis y miositis) o durante la etapa posterior al dengue (polirradiculoneuritis, encefalomielitis, neuromielitis óptica, polineuropatía y mononeuropatía) (13,14) . El diagnóstico durante el embarazo puede ser difícil, por lo que deben considerarse los cambios fisiológicos del embarazo, complicaciones relacionadas a este y otros trastornos médicos junto a los resultados de laboratorio.…”

Review of dengue, zika and chikungunya infections in nervous system in endemic areas

“…Neuroimaging is not specific. 51,52 Cerebrovascular disease Rare cases have been described of ischemic and hemorrhagic stroke. 52 Previous studies have demonstrated that endothelial cells of the blood-brain barrier are permeable to ZIKV infection and replication, and they may penetrate the endothelium, causing neuronal tissue damage.…”

“…51,52 Cerebrovascular disease Rare cases have been described of ischemic and hemorrhagic stroke. 52 Previous studies have demonstrated that endothelial cells of the blood-brain barrier are permeable to ZIKV infection and replication, and they may penetrate the endothelium, causing neuronal tissue damage. Considering that Zika has tropism and may infect endothelial cells, as demonstrated in animal models, and due to its phylogenetic relationship to DENV it is reasonable to admit a correlation between this ZIKV and strokes or brain hemorrhage.…”

“…Considering that Zika has tropism and may infect endothelial cells, as demonstrated in animal models, and due to its phylogenetic relationship to DENV it is reasonable to admit a correlation between this ZIKV and strokes or brain hemorrhage. 52…”