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Clinical and Etiological Profile of Children With Acute Viral Encephalitis in a Tertiary Care Hospital: A
Amulya Dharmagadda1, Sampada Tambolkar1, Shailaja V Mane1
1Pediatrics, Dr. D. Y. Patil Vidyapeeth, Pune, Pune, IND.
Insights
This study identified mumps as a leading cause of acute viral encephalitis in children, with factors like low GCS scores and shock impacting mortality. Early diagnosis and treatment are vital for better outcomes in pediatric encephalitis cases.
Area of Science:
- Pediatric Neurology
- Infectious Diseases
- Clinical Virology
Background:
- Acute encephalitis presents as sudden neurological symptoms and brain inflammation in children.
- Prompt diagnosis is critical for effective treatment and preventing long-term neurological damage.
Purpose of the Study:
- To investigate the clinical characteristics and etiological factors of acute viral encephalitis in pediatric patients.
- To understand the prevalence of different viral agents causing encephalitis in a tertiary care setting.
Main Methods:
- A 22-month cross-sectional study in a Pediatric Intensive Care Unit (PICU) involving 35 children (1 month to 12 years).
- Data collected through clinical evaluation, laboratory tests, and imaging studies.
- Informed consent obtained from parents/guardians.
Main Results:
- 22 (62.85%) of 35 patients had confirmed viral encephalitis; mumps was the most common virus.
- School-age children were most affected, with cases concentrated in specific regions.
- Fever, seizures, vomiting, and altered mental status were common symptoms; low vaccination rates noted.
- Glasgow Coma Scale (GCS) scores, shock, and ventilation need correlated with mortality.
- Mortality rate was 11.4%, with 17% experiencing neurological sequelae.
Conclusions:
- Mumps, HSV, and dengue are increasingly prevalent viral causes of encephalitis, surpassing Japanese encephalitis virus.
- Rabies, HSV, and H1N1 influenza virus are associated with severe clinical courses and fatal outcomes.
- GCS scores, shock, and ventilation requirements are significant prognostic indicators.
- Early detection and prompt intervention are crucial for improving patient outcomes in acute encephalitis.
Background:
Acute encephalitis refers to the clinical diagnosis of children who have a sudden onset of symptoms and show evidence of inflammatory lesions in the brain. Timely diagnosis is crucial for both lifesaving measures and the preservation of brain functions.
Objective:
The objective of the study was to determine the clinical and etiological profile of acute viral encephalitis in children within a tertiary care hospital.
Methods:
This hospital-based cross-sectional study was conducted in the Pediatric Intensive Care Unit (PICU) at Dr. D. Y. Patil Medical College, Hospital, and Research Centre in Pune. The study included children aged one month to 12 years diagnosed with suspected viral encephalitis. Over 22 months, from August 2022 to June 2024, 35 children who met the inclusion criteria were enrolled. Data collection involved clinical examinations, laboratory investigations, and imaging studies, following informed consent from the parents or guardians.
Results:
The study examined 35 patients with suspected acute encephalitis syndrome (AES) and found a male-to-female ratio of 3.4:1. Among the patients, 22 (62.85%) had a confirmed viral etiology, while 13 (37.17%) had an unknown etiology. The most common virus isolated was mumps, with school-age children most affected. The cases were concentrated in the Chikhali, Bhosari, Nigdi, and Chinchwad regions. Symptoms included fever, seizures, vomiting, and altered mental status. Low vaccination rates were observed, and the Glasgow Coma Scale (GCS) scores, shock incidence, and ventilation showed an association with mortality. Most patients required intensive care, antiedema measures, antibiotics, and antivirals. The mortality rate was 11.4%, with 17% of patients discharged with neurological sequelae.
Conclusion:
Causative agents such as mumps, herpes simplex virus (HSV), dengue, and many other viruses are now more prevalent than the Japanese encephalitis (JE) virus. Bad clinical course and fatal outcomes are observed in patients affected with rabies, HSV, and H1N1 influenza virus. Factors such as GCS scores, shock, and need for ventilation play a significant role in determining patient prognosis. Early detection and prompt treatment may aid in better outcomes for patients.
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