Dengue and Zika Viruses Detection in Children with Neurological Syndromes using Molecular Methods

Resumen

Objective. To investigate the presence of arbovirus genomes in cerebrospinal fluid (CSF) samples from children suspected of viral neurological infection, associating the results with clinical manifestations and analyzing the CSF. Methods. The cross-sectional study included CSF samples from 184 children and teenagers aged 1 day to 18 years old, with negative CSF microbiology tests. Molecular tests were carried out to detect arboviruses in the CSF. Results. Among 184 children, the genome of dengue (DENV) and zika (ZIKV) viruses were found in 44 CSF samples (23.9%) (CI 95% 17.7%-30.1%). Among those samples, 59% were positive for dengue virus, 38.6% for ZIKV, and 2.3% coinfection of DENV plus ZIKV was observed. In 67 patients with suspected infection/sepsis, 23.9% of CSF samples were positive; among 26 meningitis, 11.5% had positive results; in 22 hydrocephaly, 22.7% were positive; in 20 with convulsion, 25% had CSF positive, in 4 with encephalitis 25% were positive; in 5 intracranial hypertension, 60% were positive; 1 in 3 cases, 33.3% each, presented with neuritis and meningoencephalitis were positive; the 2 Guillain-Barré syndrome were positive. Pleocytosis occurred in 25% of positive cases, and antibiotics were used in 56.8%. We found a positivity of neurological infection by ZIKV and DENV in children even after the outbreak. Most positive samples did not show biochemical changes in the CSF. Conclusion. Molecular tests in CSF of children with neurological conditions contribute to the identification of the viral etiology, leading to less use of unnecessary antibiotics and reducing hospital stays.
Keywords: arboviruses; dengue; zika; children; molecular detection; central nervous