Abstract Details

Title The Spectrum of Neurological Complications in Dengue: The Neuroinfections Emerging in the Americas Study (NEAS) in Colombia

Topic Infectious Disease

Presentation(s) S19 - Navigating Neuroinfectious Diseases (4:54 PM-5:06 PM)

Poster/Presentation
Number 008

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.

Authors/Disclosures
Maria I. Reyes, MD (Hospital Simon Bolivar) PRESENTER	Dr. Reyes has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Merck. Dr. Reyes has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Biogen. Dr. Reyes has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Novartis. Dr. Reyes has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Roche. Dr. Reyes has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Novartis. Dr. Reyes has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Novartis.
Ana C. Villegas	Ms. Villegas has nothing to disclose.
Mariana Medina, Sr., MD	Dr. Medina has nothing to disclose.
David Acero-Garces, MD (Johns Hopkins University)	Dr. Acero-Garces has nothing to disclose.
Angela Catalina Vallejo Cajigas, MD (angela catalina vallejo cajigas)	Dr. Vallejo Cajigas has nothing to disclose.
Thanya Lagos	Thanya Lagos has nothing to disclose.
Federico Silva (Fundacion Cardiovascular De Colombia)	No disclosure on file
Melissa Gomez (Fundacion Cardiovascular de Colombia, Bucaramanga, Colombia)	No disclosure on file
Katherine Claros	Katherine Claros has nothing to disclose.
Susana Dominguez Penuela, MD	Dr. Dominguez Penuela has nothing to disclose.
Martha Moyano	Martha Moyano has nothing to disclose.
Lyda Osorio	Lyda Osorio has nothing to disclose.
Beatriz Parra	Beatriz Parra has nothing to disclose.
Carlos A. Pardo-Villamizar, MD (Johns Hopkins U, Med Dept of Neurology)	The institution of Dr. Pardo-Villamizar has received research support from National Institutes of Health. The institution of Dr. Pardo-Villamizar has received research support from Bart McLean Fund for Neuroimmunology Research .
Guillermo Gonzalez	No disclosure on file

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