Dengue cerebellitis in middle childhood from South India

We had a girl in middle childhood, who presented with fever of 7 days duration, vomiting, abdominal pain, headache, myalgia and arthralgia. The child was conscious with signs of shock. With the provisional diagnosis of dengue fever, enteric fever or scrub typhus, the child was given all supportive management. Lab investigations covering the fever panel were sent. Within 24 hours of admission, the child developed horizontal nystagmus, diplopia and intermittent dizziness. Fundus examination showed papilloedema. MRI brain showed hyperintensity of the cerebellum in T2 sections suggestive of cerebellitis. Dengue IgM antibody was positive with transaminitis and hyperferritinaemia. Child was given anti-oedema measures with supportive care. The patient recovered on day 10 of illness, and cerebellar signs subsided. Though dengue fever is commonly seen in tropical countries, the atypical presentation in the form of cerebellitis is found to be rare. The timely diagnosis helped in rapid recovery from this neurological manifestation.