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La Crosse encephalitis in children.

J E McJunkin1, E C de los Reyes, J E Irazuzta

  • 1Charleston Division, Robert C. Byrd Health Sciences Center of West Virginia University, Charleston, USA. jmcjunkin@hsc.wvu.edu

The New England Journal of Medicine
|March 15, 2001
PubMed
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La Crosse encephalitis, a mosquito-borne illness, can mimic other conditions. Early recognition of symptoms like hyponatremia and fever is crucial for managing clinical deterioration in children.

Area of Science:

  • Neuroscience
  • Infectious Diseases
  • Public Health

Background:

  • La Crosse encephalitis is a mosquito-borne viral illness.
  • It can be misdiagnosed as herpes simplex encephalitis.
  • The disease is reported in 28 states and may be underdiagnosed.

Purpose of the Study:

  • To investigate the clinical manifestations and course of La Crosse encephalitis.
  • To identify factors associated with clinical deterioration.

Main Methods:

  • Retrospective chart review of 127 hospitalized patients from 1987-1996.
  • Diagnosis confirmed by serologic testing for La Crosse virus IgM and IgG antibodies.
  • Intracranial pressure monitoring in select severe cases.

Main Results:

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  • The majority of patients were school-aged children.
  • Common symptoms included headache, fever, vomiting, seizures, and disorientation.
  • Hyponatremia occurred in 21% of patients; 11% experienced clinical deterioration, associated with decreased sodium and increased temperature.
  • 12% had neurologic deficits at discharge, with potential long-term cognitive and behavioral issues.

Conclusions:

  • La Crosse virus infection should be considered in pediatric cases of aseptic meningitis or encephalitis.
  • Hyponatremia and rising body temperature may indicate clinical deterioration.
  • Prompt diagnosis and management are essential for improving outcomes.