CNS manifestations of epidemic hemorrhagic fever. An advanced manifestation of disease associated with poor prognosis

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Abstract
The records of 134 patients with the clinical diagnosis of epidemic hemorrhagic fever (EHF) were evaluated. The conditions or 74 patients could be categorized as serious based on hemorrhagic complications and magnitude of proteinuria, BP [blood pressure] abnormality and pyrexia. Of these patients 46 had one or more CNS abnormalities. Common manifestations included confusion, meningismus and convulsions. Whereas abnormality in fever could not be related to CNS abnormality, BP disturbance, acidosis and azotemia were significantly more common among patients with CNS disease. Of the patients in this study 14% died, and all of them had CNS disturbance; mortality among patients with CNS disturbance was 41%. Evidently, the CNS manifestations of EHF are multifactorial in cause and they identify a subset of patients with an advanced stage of disease and a grave prognosis.