Hemorrhagic manifestations and encephalopathy in cases of dengue in India.

Thirty-seven serum samples and five serum-CSF pairs collected from 42 acutely ill patients admitted to hospitals in Maharashtra (Bombay, Pune and Nasik); Orissa (Raurkela) and South Goa were referred to the National Institute of Virology (NIV), Pune (Maharashtra, India) for serodiagnosis. These patients had clinical manifestations of fever, hemorrhagic manifestations, hepatomegaly, shock syndrome and encephalopathy. Sixty-six percent of patients were children below ten years of age. Serological investigations revealed infection to dengue virus in all the patients as indicated in detection of IgM antibodies predominantly to dengue viral antigens. An important outcome of the study is that 10 patients referred to NIV with a provisional diagnosis of viral encephalitis proved to be dengue.