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CASE REPORT
Year : 2013  |  Volume : 5  |  Issue : 4  |  Page : 183-186

Atypical dengue meningitis in Makkah, Saudi Arabia with slow resolving, prominent migraine like headache, phobia, and arrhythmia


Department of Neurology, Alnoor Specialist Hospital, King Abdullah Medical City, Holy Makkah, Saudi Arabia

Correspondence Address:
Kalakatawi H Mamdouh
Department of Neurology, Alnoor Specialist Hospital, King Abdullah Medical City, Holy Makkah
Saudi Arabia
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0974-777X.122021

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Although dengue meningitis is a rare presentation of dengue infection, our aim is to focus on atypical presentation of dengue meningitis that may appear in dengue endemic area like the Makkah region. We report two cases of clinical meningitis with positive dengue virus (DENV) IgM in cerebrospinal fluid, followed for minimal 3 months for their prominent attacks of migraine like headache, phobia, and arrhythmia. With special consideration to attack time, type, severity, and respond to classical therapy, using regular ECG monitoring, visual analog pain score and neuropsychological assessments were done. Both cases showed resistant migraine like headaches to classic anti-migraine therapy except for strong NSAID and narcotics with tendency to have severe to extreme severe daily migraine like headache on early to late afternoon time, associated with non-fatal arrhythmias and extreme death phobia, that resolve slowly in a minimal 3 month period. In conclusion, dengue meningitis in the endemic area may present atypically.


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2008 Journal of Global Infectious Diseases | Published by Wolters Kluwer - Medknow
Online since 10th December, 2008