Dengue-Associated Acute Demyelinating Polyradiculoneuropathy: A Case Report.

Abstract

Dengue is a viral disease endemic in tropical and subtropical regions. Four serotypes have been identified, with types 2 and 3 most frequently associated with neurological manifestations, including Guillain-Barré syndrome (GBS). A 51-year-old male patient with a history of dengue infection without severity criteria. He later develops asthenia, adynamia, and progressive weakness in the lower extremities, rapidly evolving into ascending paralysis and respiratory failure. He arrives at the emergency department with severe headache, nausea, and vomiting, presenting as hemodynamically stable but with progressive neurological deterioration.

A cranial CT scan shows no relevant findings. Neurology evaluates the patient, and immunoglobulin therapy is initiated due to suspected GBS. Laboratory tests reveal hyperglycemia (302 mg/dL) and mild hyponatremia (132 mmol/L), with a normal complete blood count and coagulation parameters. However, the patient’s condition deteriorates rapidly, leading to neurological decline and respiratory collapse. Despite therapeutic measures, the patient dies on the same day of admission. This case highlights the lethality of Guillain-Barré syndrome secondary to dengue and the importance of timely diagnosis and management. The rapid progression to respiratory failure and lack of response to treatment emphasize the need for a high index of suspicion and intensive monitoring in these patients.