Flaccid quadriparesis due to severe myositis and Bell's palsy in pediatric dengue infection

Abstract

A 10-year-old-boy was admitted with high grade continuous fever, rash, arthralgia and myalgia. From the 4^th day of fever, his myalgia increased in intensity and he developed flaccid quadriparesis on the 5^th day. Subsequently he was diagnosed to have dengue infection and myositis. He also developed right sided Bell's palsy 4 days after he became afebrile. He was treated with intravenous methyl prednisolone for 3 days followed by oral prednisolone for 1 week with resultant dramatic resolution of myalgia and weakness. Physiotherapy was advised for Bell's palsy. At follow up 2 months later, the child had regained grade 5/5 power in all four limbs, but the weakness of the facial muscles persisted.

Keywords

Dengue - flaccid quadriparesis - myositis - Bell's palsy - methyl prednisolone