Abstract

*Dr. Fatima Manzoor, Dr. Irfan Ahmad and Dr. Sara Ambreen

ABSTRACT

Objectives: Many cases of acute febrile illness show neurological complications of not only diseases with known nervous system affliction like cerebral malaria; but also of diseases which were previously not thought to be neurotropic like Dengue fever. Our study has described the various abnormalities in MRI Brain scans of these patients. Methods: A prospective study of 34 patients, who presented with acute onset of fever and some form of neurological dysfunction, underwent MRI of Brain on an elective basis. Results: Of the 34 patients, 25 (74%) had abnormal MRI scans and 9 (26%) had normal scans. The final diagnosis of patients were as follows- Acute pyogenic meningitis. (8 patients- 23%), Cerebral malaria (7 patients- 21%), Dengue encephalitis (7 patients- 21%), Leptospirosis (2 patients- 6%), Viral encephalitis of unknown etiology (2 patients- 6%), Japanese encephalitis (1 patient- 3%), HSV encephalitis (2 patients- 6%), Influenza associated encephalitis (1 patient- 3%), CNS Tuberculosis (2 patients- 6%). In 2 patients, a diagnosis could not be established even after extensive diagnostic work-up. Conclusion: In acute fever associated with neurological dysfunction, MRI brain has a good sensitivity, however, there are doubts about its specificity in conclusively diagnosing specific diseases.