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Fatal outcome in Japanese encephalitis
The American Journal of Tropical Medicine and Hygiene
|November 1, 1985
Summary
A strong immune response to Japanese encephalitis virus (JEV) indicates better survival chances. Low JEV-specific antibodies and detectable virus in cerebrospinal fluid (CSF) predict a fatal outcome in acute Japanese encephalitis patients.
Area of Science:
- Neuroscience
- Immunology
- Infectious Diseases
Background:
- Japanese encephalitis is a severe neurological disease caused by a flavivirus.
- Identifying prognostic factors is crucial for managing acute cases and improving patient outcomes.
Purpose of the Study:
- To identify clinical and laboratory risk factors at hospital admission associated with fatal outcomes in patients with acute Japanese encephalitis.
- To determine if the host's immune response is a predictor of survival.
Main Methods:
- Retrospective study of 49 consecutive patients with laboratory-confirmed acute Japanese encephalitis.
- Analysis of clinical data, cerebrospinal fluid (CSF) and serum samples for Japanese encephalitis virus (JEV) and specific antibodies (IgG, IgM).
- Correlation of admission findings with patient mortality.
Main Results:
- 33% of patients (16 out of 49) died.
- Fatal outcomes were associated with infectious JEV in CSF, low JEV-specific IgG and IgM levels in CSF and serum, and a severely depressed sensorium.
- Age, sex, illness duration, and CSF inflammatory markers were not significant risk factors.
Conclusions:
- A vigorous virus-specific immunoglobulin response, both systemic and within the central nervous system, is a favorable prognostic marker for survival in acute Japanese encephalitis.
- The presence of infectious virus in CSF and a weak antibody response are indicators of a poor prognosis.