Purpose or Case Report: The dengue virus, an RNA virus from the Flaviviridae family, is typically considered non-neurotropic. Dengue encephalitis is caused by four strains DENV1 to DENV4. While the dengue virus generally does not affect the nervous system, DENV2 and DENV3 can be neurotropic. Symptoms of dengue encephalitis include headaches, seizures, and changes in consciousness.

In dengue encephalitis, areas most commonly affected are the basal ganglia, thalamus, brainstem, cerebellum, cortical white matter, periventricular white matter, and cortical gray matter. On T2-weighted and FLAIR sequences, these areas appear hyperintense, while on T1-weighted images, the lesions may be iso- or hypointense. Micro-hemorrhages show as blooming on susceptibility-weighted MRI. MRI is essential for the initial assessment of suspected dengue encephalitis and for patients with dengue fever experiencing worsening neurological symptoms.

Our presentation highlights the need to understand the relevant imaging findings and possible causes of neurological issues in dengue-infected patients, as this is crucial for accurate diagnosis and effective treatment, leading to better outcomes.
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