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

The records of 134 patients with the clinical diagnosis of epidemic hemorrhagic fever (EHF) were evaluated. The conditions of 74 patients could be categorized as "serious" based on hemorrhagic complications and magnitude of proteinuria, BP abnormality, and pyrexia. Forty-six of these patients with a serious condition 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. Fourteen percent of the patients in this study died, and all of them had CNS disturbance; mortality among patients with CNS disturbance was 41%. These results suggest that 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.