ACUTE ENCEPHALITIS SYNDROME IN CHILDREN: A DESCRIPTIVE CROSSSECTIONAL STUDY IN A RURAL BASED TERTIARY CARE HOSPITAL IN INDIA

2021 ◽  
pp. 9-12
Author(s):  
Bapan Kabiraj ◽  
Soumya Gayen ◽  
Ebna Rushad ◽  
Subinay Mandal
Keyword(s):  
Scrub Typhus ◽  
Adult Population ◽  
Tertiary Care ◽  
Abnormal Behavior ◽  
Cns Infection ◽  
Care Hospital ◽  
Term Outcome ◽  
Case Record ◽  
Acute Encephalitis Syndrome ◽  
Acute Encephalitis

Background: Acute Encephalitis Syndrome (AES) is a group of clinically similar neurologic manifestations due to encephalitis. AES is an important cause of mortality and morbidity in children in various parts of India. Most of the study has been done in adult population. So, I have done this study to evaluate clinical prole, short-term outcome and changing trends of etiologies of acute encephalitis in children. Methods: This is an institution-based descriptive cross-sectional study including sixty children aged one month to twelve years conducted over a period of one and half years in the pediatric department of a rural based medical college in India. Data collected in predesigned case record proforma and analysed with SPSS software version 25. Results: Incidence rate 4 per 1000 patients per year with 2 to 6 years age group with males predominating. Important presenting complaints were fever, convulsion, abnormal behavior, rash, vomiting, headache, lethargy, aphasia and quadriparesis. Poor Glasgow coma score (GCS), meningeal sign and raised intra cranial pressure were important examination ndings. Dengue and scrub typhus were important emerging etiologies replacing Japanese encephalitis. Overall mortality is around 13%. Conclusions:All febrile children with altered sensorium should be investigated for central nervous system (CNS) infection, unless clear evidence of another diagnosis. Viruses are the main culprit with Dengue and Scrub typhus being the important emerging etiology. Timely diagnosis and treatment can reduce morbidity and mortality signicantly.

scholarly journals Clinical profile and outcome of children admitted with acute encephalitis syndrome

2020 ◽  
Vol 8 (1) ◽  
pp. 60
Author(s):  
Arpita Adhikari ◽  
Mona Gajre ◽  
Rini Kothari ◽  
Nayan Chaudhari ◽  
Deepali Sangale
Keyword(s):  
Tertiary Care ◽  
Case Definition ◽  
Clinical Profile ◽  
Abnormal Behavior ◽  
Care Hospital ◽  
Term Outcome ◽  
Mortality And Morbidity ◽  
Acute Encephalitis Syndrome ◽  
Acute Encephalitis ◽  
Wide Range

Background: Acute encephalitis syndrome (AES) is an important cause of mortality and morbidity in children. We undertook this study for better understanding of clinical profile and outcome of AES in our settings.Methods: It was a prospective observational study. We studied 15 patients of AES admitted in a tertiary care hospital from December 2016 to May 2017. For investigating AES cases, WHO case definition was adopted. Clinically a case of AES is defined as fever or recent history of fever with change in mental status (including confusion, disorientation, coma, or inability to talk) and/or new onset of seizures (excluding simple febrile seizures). Other early clinical findings could include an increase in irritability, somnolence or abnormal behavior greater than that seen with usual febrile illness. We evaluated their clinical characteristics and outcomes at the time of discharge.Results: Fever, altered sensorium, seizures and headache were the most common symptoms observed in this study. Among 15 cases of AES patients, 6 (40%) recovered completely, while 5 (33.33%) cases had neurological sequelae with a wide range of severity varying from mild to severe at the time of discharge, 4 (26.66%) patient died in the hospital.  Conclusions: This study offers a description of the present etiology, clinical presentation and short-term outcome of AES. Use of mechanical ventilation, lower Glasgow coma score, and concurrent seizures are predictors for a poor outcome. Reporting and appropriate workup of all cases would strengthen the AES surveillance and help in reducing the morbidity and mortality due to this disorder.

LABORATORY PROFILE OF INDOOR PATIENTS ADMITTED WITH ACUTE ENCEPHALITIC SYNDROME IN A TERTIARY CARE CENTRE OF NORTH-BENGAL

2021 ◽  
pp. 76-78
Author(s):  
Smarajit Banik ◽  
Debasis Chakrabarti ◽  
Sandip Saha ◽  
O P. Pandey ◽  
Dipanjan Bandyopadhyay
Keyword(s):  
Tertiary Care ◽  
Care Hospital ◽  
Tertiary Care Centre ◽  
Cross Sectional ◽  
Study Region ◽  
Male Predominance ◽  
Acute Encephalitis Syndrome ◽  
Acute Encephalitis ◽  
Wbc Count ◽  
North Bengal

Background: Acute encephalitis syndrome (AES) is dened as the acute-onset of fever and a change in mental status (including signs and symptoms such as confusion, disorientation, delirium or coma) and/or new-onset of seizures (excluding simple febrile seizures) in a person of any age at any time of the year. Most AES is considered to be due to a viral-encephalitis, virus like West Nile, Herpes simplex virus, Flaviviruse like JE and dengue are more prevalent in South East Asia. Methods: This observational Cross sectional Study was conducted in the indoor patients of Department of Medicine at Tertiary care Hospital in North Bengal from May 2013 to April 2014. All consecutive patients of AES admitted during this period were included in the study. The study region covers the various districts of North Bengal. Template was generated in MS excel sheet and analysis was done on SPSS 20.0 software. Results: Among 104 acute encephalitis syndrome patients, 68 (65.38%) were male and 36 (34.62%) were female. The majority of pts (54.81%) were >40yrs of age. The lowest wbc count was 3000/cumm and highest was 21,200/cumm with mean wbc count being 10462.56±3567.832/cumm. Asignicant number 56 (53.85%) of patients had serum potassium levels between 2.5-3.5meq/dl. The no. of JE Positive patients was 75 (72.12%) which may be due to the local endemicity of the disease Conclusions: Majority of cases were in the age-group of more than 40 years, with male predominance. The no. of JE Positive patients was 75 (72.12%) which may be due to the local endemicity of the disease.

CLINICAL PROFILE OF AES CASES IN A TERTIARY CARE CENTER OF NORTH BENGAL

2021 ◽  
pp. 71-73
Author(s):  
Sharma S ◽  
Chakrabarti D ◽  
Saha S ◽  
Banik S ◽  
Mondal S
Keyword(s):  
Scrub Typhus ◽  
Care Center ◽  
Tertiary Care ◽  
Babinski Sign ◽  
Neck Stiffness ◽  
Cross Sectional ◽  
Altered Sensorium ◽  
Acute Encephalitis Syndrome ◽  
Acute Encephalitis ◽  
North Bengal

Introduction: The clinical features of Acute Encephalitis syndrome (AES) vary widely across the world and little documentation is available from North Bengal. Materials and methods: A cross –sectional observational study was conducted at the Department of Medicine of a teaching hospital in North Bengal. 104 AES cases were enrolled and clinically evaluated and investigated as per the study protocol. Results:JE (72%) was most common causative agent followed by HSV Encephalitis (11.5%), Scrub Typhus (9.6%) and Dengue Encephalitis (2.88%). Male cases were predominant than female in our study. Fever and altered sensorium were most common presentation followed by seizures (51.9%), headache (29.8%), vomiting (18.2%), and hemiplegia (4.8%). Neurological evaluation revealed 80% of the patients had neck stiffness followed by positive Babinski sign (45.19%) and hypertonia (35%). Conclusions: JE is the commonest cause of AES in North Bengal and seizures are the commonest neurological manifestation after altered sensorium.

scholarly journals A clinico-epidemiological study of acute encephalitis syndrome with multi organ dysfunction

2017 ◽  
Vol 4 (3) ◽  
pp. 745
Author(s):  
Mahima Mittal ◽  
Komal P. Kushwaha ◽  
Ashok K. Pandey ◽  
Milind M. Gore
Keyword(s):  
Tertiary Care ◽  
Clinical Manifestations ◽  
Public Health Problem ◽  
The Body ◽  
Organ Involvement ◽  
Care Hospital ◽  
Viral Etiology ◽  
Biochemical Tests ◽  
Acute Encephalitis Syndrome ◽  
Acute Encephalitis

Background: Acute Encephalitis Syndrome (AES) is a pressing public health problem in Eastern Uttar Pradesh, India. Japanese Encephalitis (JE), which has been endemic in this region, has shown a declining trend. AES not due to JE (Non JE) constitutes more than 75% of all cases and is associated with non-neurological clinical manifestations also. The etiology of Non JE AES is still unknown. We studied the clinic-epidemiological profile of AES, and compared Non JE AES to JE.Methods: This study was done in a tertiary care hospital in children 1-15 years. Clinical features, CSF analysis, biochemical tests, radiological features and outcome were studied in AES cases.Results: Out of 505 patients, 27 had an identifiable non-viral etiology. JE was a cause in 31/478(6.48%) patients. The remaining 447 patients were labeled as Non JE AES. Headache at presentation (25.8% vs. 10.7%) and hypertonia (22.6% vs. 9.8%) were significantly higher in JE patients. Swelling over the body (21.25%vs 3.2%) and hypotonia (25.7% vs. 3.2%) were significantly more common in Non JE AES. Although cardiac involvement and multi-organ involvement was more in Non JE AES, the difference was not statistically significant. Overall mortality was 32.42%.Conclusions: JE is no longer an important cause of AES in this region. Swelling over the body, floppiness and multi organ involvement are predominant features of Non JE AES. Although many infectious diseases can present with similar features, a viral etiology seems most likely. Further efforts are needed to identify etiology.

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. 

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