scholarly journals Clinical profile and predictors of outcome in children admitted to PICU with acute encephalitis syndrome

2017 ◽  
Vol 4 (4) ◽  
pp. 1214 ◽  
Author(s):  
Ekambaranath Sambasivam ◽  
Jayakumar Muthaiyan ◽  
Sreedivya Mohan ◽  
Aravind Malayappan Ayyavoo ◽  
Ganesh Jayachandran
Keyword(s):  
Tamil Nadu ◽  
Case Fatality ◽  
Unknown Origin ◽  
Clinical Profile ◽  
Prognostic Indicators ◽  
Predictors Of Outcome ◽  
Diagnostic Challenge ◽  
Female Ratio ◽  
Acute Encephalitis Syndrome ◽  
Acute Encephalitis

Background: Acute encephalitis syndrome (AES) is defined as the acute onset of fever and change in mental status (including symptoms such as confusion, disorientation, coma or inability to talk) and/or new onset seizures (excluding febrile seizures) in a person of any age at any time of the year. AES is reported mainly from Assam, Bihar, Tamil Nadu, Karnataka, Uttar Pradesh contributing approximately to 80% cases with case fatality rate of 20-25%. In view of paucity of clinical studies from Tamil Nadu, this study was undertaken to have a better insight on the clinical profile and prognostic indicators of AES in children. Objective of present work was to study the clinical profile and predictors of outcome of Acute encephalitis syndrome patients admitted in PICUMethods: This retrospective study was conducted in children with AES admitted to PICU, Stanley medical college over a period of 1year (May 2015-May 2016). 30 cases were studied. Clinical features, demography, immunisation status, and outcome were recorded. Results of blood investigations, peripheral smear, neuroimaging, CSF analysis and IgM ELISA for HSV, JE, CMV, Dengue were recorded and analysed.Results: Mean age of cases was 3.5±3.3years. Male to female ratio was 1.1:1. Etiology included HSV (6.67%), malaria (3.33%), dengue (3.33%), tubercular meningitis (3.33%), AES of unknown origin (83.3%) 11, Most common presentation was seizures 21 (70%). 17 (56.6%)presented with GCS <8. 11 (36.6%) required inotrope support, 16 (53.4%) were ventilated. Laboratorial findings included, leukocytosis in 17 (66.7%), dysglycemia in 12 children (39.99%), hyponatremia in 10 (33.33%), hypernatremia in 8 (26.67%) Mortality was observed in 11 cases (36.67%). Hyponatremia (p=0.02) and cases requiring ionotrope support on admission (p=0.0003) were significantly associated with mortality.Conclusions: There was no case of Japanese encephalitis. Hyponatremia being significantly associated with mortality among children with AES, warrants detailed evaluation to define the etiology which will aid in appropriate management. Maintaining euvolemia, prompt identification of shock and appropriate use of inotropes is of utmost importance. Varied and changing etiologies of AES poses a diagnostic challenge. 

scholarly journals Study of acute encephalitis syndrome in children

1970 ◽  
Vol 6 (1) ◽  
pp. 7-13 ◽  
Author(s):  
YR Khinchi ◽  
A Kumar ◽  
S Yadav
Keyword(s):  
Japanese Encephalitis ◽  
Catchment Area ◽  
Case Fatality Rate ◽  
Case Fatality ◽  
Fatality Rate ◽  
Medical Sciences ◽  
Hospital Records ◽  
Acute Encephalitis Syndrome ◽  
Acute Encephalitis ◽  
Supportive Interventions

Objective: To determine the profile and outcome of children admitted with Acute Encephalitis Syndrome (AES) and to find out the prevalence of Japanese Encephalitis (JE) IgM antibodies positive cases among these patients with their case fatality rate (CFR). Materials and methods: Study consist of retrospective analysis of hospital records of children up to 15 years of age admitted with diagnosis of AES in pediatric wards of College of Medical Sciences-Teaching Hospital, Bharatpur from January 2007 to December 2008. Results: During two years, 61 patients of AES were admitted. Male and female patients were 33 and 28 respectively. Meningitis accounted for 29 and encephalitis for 32 patients. JE IgM seropositive cases contributed for 18% of all AES cases. Case fatality for JE was 16.6%. Conclusions: Japanese Encephalitis is endemic in catchment area of the hospital. JE has significant morbidity and mortality which can be prevented by immunization and mortality can be reduced if supportive interventions are provided in time. Key words: AES; JE; CFR. DOI: 10.3126/jcmsn.v6i1.3596 Journal of College of Medical Sciences-Nepal, 2010, Vol. 6, No. 1, 7-13  

scholarly journals Analysis of outcome of acute encephalitis syndrome after inclusion of coverage against scrub typhus

2018 ◽  
Vol 6 (1) ◽  
pp. 10
Author(s):  
Ruchi Jha ◽  
Anil Kumar Jaiswal
Keyword(s):  
Scrub Typhus ◽  
Controlled Trial ◽  
Case Fatality ◽  
Standard Operating Procedure ◽  
Acute Encephalitis Syndrome ◽  
Acute Encephalitis ◽  
Number Of Patients ◽  
Management Of Complications ◽  
Significant Difference ◽  
Before And After

Background: Acute encephalitis syndrome (AES) has emerged as a major epidemic in Bihar and is associated with high mortality. Owing to the increasing burden of disease and its associated morbidity and mortality, studies were undertaken to evaluate specific etiology of AES. Some studies suggested emergence of scrub typhus as a major cause of AES accounting for about 25% of the cases1. A Standard Operating Procedure (SOP) was developed for treatment of AES cases in Bihar which included addition of Injection Azithromycin (@ 10 mg/kg for 7 to 10 days in case of suspected mycoplasma/rickettsial infection. The objective of the study is to compare the outcome of AES before and after the inclusion of coverage against rickettsial infection.Methods: It is a randomized controlled trial conducted in the Department of Pediatrics, Patna Medical College and Hospital, Patna from January 2016 to August 2018.Results: Total number of patients enrolled in both the groups were 127 and 88 respectively. No significant difference were seen in the baseline socio- demographic characteristics of the two groups. Case Fatality Rate in the 1st group (without inclusion of Azithromycin) was 39.3% while in the 2nd Group (with Azithromycin) was 12.5%.Conclusions: Due to the emergence of scrub typhus as a major etiological factor for AES, inclusion of coverage against it along with measures like widespread immunization against Japanese Encephalitis and prompt management of complications and euglycemia, can result in steady decline in the death rates due to AES.

scholarly journals A study of Acute Encephalitis Syndrome – Clinical profile, aetiology, and outcome

2021 ◽  
Vol 7 (4) ◽  
pp. 283-287
Author(s):  
Mayank A Patel ◽  
Pranav B Joshi ◽  
Rakesh I Bharodiya ◽  
Sudhir V Shah ◽  
Shalin D Shah
Keyword(s):  
Tertiary Care ◽  
Autoimmune Encephalitis ◽  
Case Definition ◽  
Clinical Profile ◽  
Western India ◽  
Tertiary Care Centre ◽  
Acute Encephalitis Syndrome ◽  
Acute Encephalitis ◽  
Extensive Evaluation ◽  
Number Of Patients

We aimed to study the clinical profile and etiology of Acute Encephalitis Syndrome (AES) in a tertiary care centre of western India.All patients evaluated by the neurology department, who fulfilled the standardised case definition for encephalitis (given by International Encephalitis Consortium) over 2 year period were screened. Routine laboratory investigations, CSF, Neuroimaging and EEG were done in all patients. Short term follow-up of one month was done to see the outcome.: Out of total 85 patients of AES seen over two years; viral etiology was identified in 26 (30.5%) patients; 8 (9.4%) patients had autoimmune cause and in 53 (62.4%) patients, no specific ethology could be found. Long duration of symptom onset to hospitalisation, seizures, abnormal behaviour, involuntary movements (automatism, dyskinesia, or dystonia), and autonomic dysfunction favours a diagnosis of autoimmune encephalitis. At one month, good outcome (mRS &#60;2) was seen in 51(60%) patients and 34 (40%) patients had a poor outcome (mRS &#62; 2), out of which 29(34.1%) patients expired. Viral encephalitis was the commonest cause of AES; followed by autoimmune encephalitis. Specific cause could not be ascertained in large number of patients, even after extensive evaluation. AES patients had prolonged hospital stay and significant morbidity and mortality.

scholarly journals Incidence of Japanese encephalitis virus among patients presenting with acute encephalitis syndrome in a tertiary care hospital, West Bengal, India

2021 ◽  
Vol 8 (12) ◽  
pp. 5947
Author(s):  
Arup Roy ◽  
Poulami Saha ◽  
Asraful Islam ◽  
Rajdeep Saha ◽  
Abhishek Sengupta ◽  
...  
Keyword(s):  
Japanese Encephalitis Virus ◽  
Japanese Encephalitis ◽  
West Bengal ◽  
Tertiary Care ◽  
Case Fatality ◽  
Encephalitis Virus ◽  
Care Hospital ◽  
Serum Samples ◽  
Acute Encephalitis Syndrome ◽  
Acute Encephalitis

Background: Japanese encephalitis virus (JEV) is a flavivirus related to dengue, yellow fever and West Nile viruses, and is spread by mosquitoes. JEV is the main cause of viral encephalitis in many countries of Asia with an estimated 68000 clinical cases every year. Although symptomatic Japanese encephalitis (JE) is rare, the case-fatality rate among those with encephalitis can be as high as 30%. Permanent neurologic or psychiatric sequelae can occur in 30-50% of those with encephalitis. This study was conducted to find the incidence of JEV IgM in patients presenting with acute encephalitis syndrome (AES) in Raiganj govt. medical college and hospital, Uttar Dinajpur, West Bengal, India.Methods: Blood and CSF samples were collected from patients presenting with AES. IgM antibody capture ELISA was performed on the CSF and serum samples by JE virus MAC ELISA kit.Results: The overall prevalence of JEV IgM was 13.8%. Among the positive cases male comprised of 71.4% and female 28.5%. The most common age group affected was above 16 years of age. JEV prevalence was present throughout the year with high number of cases between the monsoon and post monsoon seasons.Conclusions: This study demonstrates the endemicity of JEV in Uttar Dinajpur district of West Bengal, India. As most of the JE cases are asymptomatic strengthening the existing surveillance system is required to find out the actual scenario of JEV in West Bengal. Control of vectors, early diagnosis and treatment, vaccinations are the key to decrease the morbidity and mortality caused by JEV. 

scholarly journals Clinical Profile and Outcome of Japanese Encephalitis in Children Admitted with Acute Encephalitis Syndrome

2013 ◽  
Vol 2013 ◽  
pp. 1-5 ◽  
Author(s):  
Gitali Kakoti ◽  
Prafulla Dutta ◽  
Bishnu Ram Das ◽  
Jani Borah ◽  
Jagadish Mahanta
Keyword(s):  
Japanese Encephalitis ◽  
Viral Disease ◽  
Clinical Profile ◽  
College Hospital ◽  
Meningeal Irritation ◽  
Medical College ◽  
Presenting Symptoms ◽  
Acute Encephalitis Syndrome ◽  
Acute Encephalitis ◽  
A Prospective Study

Japanese encephalitis (JE) is an arthropod borne viral disease. Children are most commonly affected in Southeast Asian region showing symptoms of central nervous system with several complications and death. The clinical characteristics and outcomes in pediatric JE patients hospitalized with acute encephalitis syndrome (AES) are still poorly understood. A prospective study was conducted in pediatric ward of Assam Medical College Hospital to evaluate the clinical profile and outcome of JE in children. A total of 223 hospitalized AES cases were enrolled during March to December 2012. Serum and cerebro spinal fluids were tested for presence of JE specific IgM antibody. 67 (30%) were found to be JE positive. The most common presenting symptoms in JE patients were fever (100%), altered sensorium (83.58%), seizure (82.08%), headache (41.79%), and vomiting (29.85%). Signs of meningeal irritation were present in 55.22% of cases. Around 40.29%, JE patients had GCS ≤ 8. Among the JE patients, 14.7% died before discharge. The complete recoveries were observed in 63.9% of cases, while 21.3% had some sort of disability at the time of discharge. JE is still a major cause of AES in children in this part of India. These significant findings thus seek attentions of the global community to combat JE in children.

Viral aetiology and clinico-epidemiological features of acute encephalitis syndrome in eastern India

2014 ◽  
Vol 142 (12) ◽  
pp. 2514-2521 ◽  
Author(s):  
S. K. RATHORE ◽  
B. DWIBEDI ◽  
S. K. KAR ◽  
S. DIXIT ◽  
J. SABAT ◽  
...  
Keyword(s):  
Case Fatality ◽  
Eastern India ◽  
Varicella Zoster ◽  
Acute Encephalitis Syndrome ◽  
Acute Encephalitis ◽  
Epidemiological Features ◽  
Viral Aetiology ◽  
Cranial Nerve Palsies ◽  
Simultaneous Infection ◽  
Simplex Virus

SUMMARYThis study reports clinico-epidemiological features and viral agents causing acute encephalitis syndrome (AES) in the eastern Indian region through hospital-based case enrolment during April 2011 to July 2012. Blood and CSF samples of 526 AES cases were investigated by serology and/or PCR. Viral aetiology was identified in 91 (17·2%) cases. Herpes simplex virus (HSV; types I or II) was most common (16·1%), followed by measles (2·6%), Japanese encephalitis virus (1·5%), dengue virus (0·57%), varicella zoster virus (0·38%) and enteroviruses (0·19%). Rash, paresis and cranial nerve palsies were significantly higher (P < 0·05) with viral AES. Case-fatality rates were 10·9% and 6·2% in AES cases with and without viral aetiology, respectively. Simultaneous infection of HSV I and measles was observed in seven cases. This report provides the first evidence on viral aetiology of AES viruses from eastern India showing dominance of HSV that will be useful in informing the public health system.

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