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Dengue haemorrhagic fever (DHF) is one of the leading causes of
morbidity and mortality in the tropical and subtropical countries.
Although, the dengue virus when compared to other arboviruses do not cause
significant central nervous system involvement it can be an important
cause of encephalitis and Encephalopathy when taking in to account the
large epidemics that occur due to the virus.
DHF is characterized by plasma leakage and bleeding manifestations.
However, direct involvement of the brain by the dengue virus has been
shown in both autopsy studies  and in children who had clinical
features of enchephalitis. Encephalopathy in children with DHF may
occur due to a variety of reasons such as direct involvement of the brain,
liver failure, renal failure, cerebral oedema, electrolyte imbalances,
vasculitis and due to fluid extravasation. It has been shown that
children who developed encephalopathy had higher levels of elevated liver
enzymes than those who did not. Moreover, higher mortality rates (22%)
were seen in patients with features of encephalopathy.
Therefore, in area endemic for dengue infection when patients present
with features of either encephalitis or Encephalopathy it is important to
suspect dengue infection and investigate for it.
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