DOI: https://doi.org/10.36347/sjams.2024.v12i11.019

Pages: 1550-1557

Background: Dengue encephalopathy represents a severe neurological complication of dengue infection, yet comprehensive data from Bangladesh remains limited despite the country's high disease burden. Objective: To analyze the clinical characteristics, laboratory parameters, neuroimaging findings, and outcomes of dengue encephalopathy cases in Bangladesh, and to identify prognostic factors for adverse outcomes. Methods: This prospective observational study examined 200 cases of dengue encephalopathy across five tertiary care centers in Bangladesh from January 2020 to December 2023. Diagnosis was confirmed through NS1 antigen and/or dengue-specific antibody testing. Clinical features, laboratory parameters, neuroimaging findings, and outcomes were analyzed using standardized protocols. Results: The cohort (59% male; mean age 34.6±15.3 years) showed neurological manifestations at a median of 5.2 days post-fever onset. Common presentations included altered consciousness (100%), seizures (43%), and focal neurological deficits (27%). Significant neuroimaging findings were observed in 56% of cases, predominantly cerebral edema (28.5%) and meningeal enhancement (17%). ICU admission was required in 43% of cases. The overall mortality rate was 12%, while 71% achieved complete neurological recovery. Multivariate analysis identified GCS <8 at admission (OR: 3.8, 95% CI: 2.1-6.9), presence of shock (OR: 2.9, 95% CI: 1.8-4.7), and platelet count <20,000/µL (OR: 2.4, 95% CI: 1.5-3.8) as independent predictors of poor outcomes. Conclusion: Dengue encephalopathy in Bangladesh presents with distinct clinical patterns and carries significant mortality risk. Early recognition of prognostic factors, standardized management protocols, and adequate critical care support are crucial for improving outcomes. The findings provide a framework for managing similar cases in endemic regions and highlight areas for future research.