RESUMO
We report a case of Miller Fisher syndrome and bilateral demyelinating optic neuropathy suggesting the possible involvement of central nervous system in this syndrome. The optic neuritis was confirmed by visual evoked potential.
Assuntos
Doenças Desmielinizantes/diagnóstico , Potenciais Evocados Visuais , Síndrome de Miller Fisher/diagnóstico , Neurite Óptica/diagnóstico , Adulto , Humanos , Masculino , Síndrome de Miller Fisher/complicações , Neurite Óptica/complicaçõesRESUMO
BACKGROUND: One of the main challenges for clinical research in dengue is the low validity of clinical diagnosis. OBJECTIVE: To analyze clinical and laboratory data as predicitve factors of dengue diagnosis at Evandro Chagas Clinical Research Institute, Oswaldo Cruz Foundation, during the 2001-2002 dengue outbreak in Rio de Janeiro. METHODS: Cross sectional study comparing clinical laboratory data collected from the National Information System for Compulsory Notification Diseases (SINAN) in two serologically confirmed groups: dengue D (N = 453) and non-dengue ND (N = 80). RESULTS: Fever, exanthema, itching, mean platelet count < 150,000, WBC count < 4,000 and absence of vomiting and of abdominal pain help to distinguish D from ND groups. When considered individually, these signs and symptoms enhance diagnostic sensitivity and, when used in combination, improve specificity. CONCLUSION: A combination of symptoms not necessarily considered indicative of dengue diagnosis could improve surveillance and medical decision-making in simple clinical settings.