Bilateral papillary edema secondary to cerebral pseudotumor related to dengue
There are about 50 million infection sand 500,000 hospitalizations with dengue annually .This is a viral infection with 4 serotypes. It can manifest like simple cold, hemorrhagic fever and shock. Neurological and ocular manifestations are uncommon,but there is an increasing number of related cases.Neurological manifestations of the infection are encephalitis ,vascular events, hemorrhage or thrombosis ,among others. The predominant is encephalitis. The most common eyepieces are: retrorbitary pain, retinal and sub-conjunctival haemorrhages. Optic neuritis, maculopathy ,choroid aleffusion,papillary edema,retinal detachment, and uveitis may also occur .The aim of this report is to describe a rare clinical case of bilateral papillary edema secondary to cerebral pseudo tumor related to dengue.
patient's chart analysis
The prognosis of ocular and neurological manifestations is mostly good and can resolve spontaneously .The use of steroids to treat visual changes is controversial .Because ocular abnormalities are being more common in dengue patients, mydriasis funduscopy should be performed routinely in all patients with moderate or severe forms of the disease.
Dengue fever is a major global public health disease.There ported incidence of papillary edema secondary to dengue ranged from 0-1.5%. Common signs included relative pupillary defect afferent, optic disc edema and vessel engorgement.
There are also cases of cerebral venous thrombosis, which is caused by severe dehydration resulting from plasma leakage; associated with dengue .This may lead to a pseudotumor related papillary edema. The ocular changes in dengue are usually self-limiting, with most findings that resolve without specific treatment. The differential diagnosis of papill edema is of essential importance for both the conduct and the prognosis . And imaging exams have great utility.
Dengue; Bilateral papillary edema; pseudotumor
CLINICAL RETINA
Fundação Dr João Penido Burnier - São Paulo - Brasil
Guilherme Ferreira Bandeira Coelho Dias, Tiago Ameida Carvalho, Vinicius Clementino Falcão, Mariana Botelho Dias Souza, Jéssica Araujo Sousa, Valdez Melo, Marcio Augusto Nogueira Costa, Rafael Nojiri Moreira