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Outcome of Encephalitis in Pediatric Intensive Care Unit
Kam-Lun Ellis Hon1, Yin Ching K Tsang2, Lawrence C N Chan2
1Department of Pediatrics, The Chinese University of Hong Kong, Prince of Wales Hospital, 6/F, Clinical Sciences Building, Shatin, Hong Kong. ehon@hotmail.com.
Indian Journal of Pediatrics
|April 8, 2016
Summary
Viral encephalitis in pediatric intensive care units (PICUs) leads to high mortality and severe neurodevelopmental impairments in survivors. Early identification of pathogens and risk factors is crucial for improving outcomes in these critically ill children.
Area of Science:
- Pediatric critical care medicine
- Infectious diseases
- Neuroscience
Background:
- Encephalitis is a serious condition affecting the brain, particularly in children.
- Identifying causative pathogens and understanding outcomes in pediatric intensive care units (PICUs) is essential for effective management.
Purpose of the Study:
- To review the pathogens, morbidity, and mortality associated with viral and infectious encephalitis in pediatric intensive care unit (PICU) patients.
- To analyze risk factors and outcomes, including neurodevelopmental impairments, in pediatric encephalitis cases.
Main Methods:
- A retrospective chart review was conducted for all patients diagnosed with encephalitis and admitted to the PICU between 2002 and 2014.
- Data collected included identified pathogens, clinical course, treatments received, and patient outcomes.
Main Results:
- Encephalitis represented 2.7% of PICU admissions but contributed to 11.8% of PICU mortality.
- Viruses were identified in 59% of cases, with enteroviruses and herpes viruses found in cerebrospinal fluid (CSF).
- Over 25% of patients died, and 55% of survivors experienced moderate-to-severe neurodevelopmental impairments. Male gender and corticosteroid use were associated with poorer survival.
Conclusions:
- Encephalitis carries a significant mortality rate and leads to substantial long-term neurodevelopmental deficits in pediatric patients, even with intensive care.
- Corticosteroid treatment may be associated with reduced survival chances in pediatric encephalitis patients.
- No emerging outbreaks of encephalitis were observed during the study period.
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