A study of acute febrile encephalopathy with special reference to viral etiology

Karmarkar, Santosh; Aneja, Satinder; Khare, Shashi; Saini, Arun; Seth, Anju; Chauhan, Bks

doi:10.1007/s12098-008-0150-2

Cited by 61 publications

(71 citation statements)

References 14 publications

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“…In the current study signs of meningeal irrita on were evaluated in 46 children who were of more than two years of age among whom posi ve results were seen in 50% of children similar to that observed by Karmakar et al 10 and to correlate clinical and radiological features of pa ents with viral encephali s.\n\nMETHODS: A prospec ve hospital based study conducted on the consecu ve pa ents admi ed in a pediatric unit during the period of 1(st In our study, neck s ff ness was present in 46.3% of children. Various authors have reported diff erent frequencies of neck s ff ness ranging from 30% to 50% of children with febrile encephalopathy 2,12 .…”

Section: Discussionsupporting

confidence: 83%

“…As noted by Khinchi et al from Nepal, this study also revealed increased number of cases during the monsoon season of July to August which may be due to the increase transmission of the diseases during the monsoon months 13 . Similarly acute febrile encephalopathy was found to occur more frequently in people of low socioeconomic status in our country, present in 32 (59%) children, which was similar to that noted in India 10 and to correlate clinical and radiological features of pa ents with viral encephali s.\n\nMETHODS: A prospec ve hospital based study conducted on the consecu ve pa ents admi ed in a pediatric unit during the period of 1(st. This could be because increased incidence of overcrowding, poor hygiene, poor nutri onal status and subop mal immunity increases suscep bility to various infec ous diseases, febrile encephalopathy being one of them.…”

Section: Discussionsupporting

confidence: 79%

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Clinical Profile of Children with Acute Febrile Encephalopathy in a Tertiary Health Care Center of Nepal

Sharma

Sarmah

Kayastha

et al. 2016

J. Nepal Paedtr. Soc.

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Introduction: Acute febrile encephalopathy is a common and severe neurological syndrome that is associated with significant morbidity and mortality in children. The etiologies differ according to geographical regions and appropriate and efficient protocols for investigations and management requires proper understanding of various potential etiologies. Material and Methods: In this prospective observational study, 54 children of one month to 14 years presenting to the College of Medical Sciences, Bharatpur, Nepal with acute onset of fever with altered sensorium were clinically evaluated and investigated. Clinical examinations included temperature, pulse rate, heart rate, blood pressure, coma severity by GCS, respiratory pattern and detail systemic and CNS examination. Etiology of acute febrile encephalopathy was based on clinical history, examination and relevant laboratory investigations. Results: The incidence of acute febrile encephalopathy was 5.5% of the total hospital admissions. There were 35(64.8%) boys and 19(35.2%) girls. The maximum number of children 24(44.4%) were within the age group of one to five years of age. The most common presenting complains besides fever and altered sensorium were seizures and vomiting which was present in 59.3% and 46.3% of children respectively. Signs of meningeal irritation, hypertonia, brisk deep tendon reflexes and extensor plantar response was present in 50%, 24%, 29.6%, and 44.4% respectively. The diagnosis based on clinical findings and laboratory investigations were viral encephalitis 34(63%), bacterial meningitis 12(22.2%), cerebral malaria 4(7.4), enteric encephalopathy 3(5.6%) and hepatic encephalopathy 1(1.9%). Conclusion: Viral encephalitis and bacterial meningitis are the most common cause of acute febrile encephalopathy. Preventive strategies can be undertaken to decrease the incidence.

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Section: Discussionsupporting

confidence: 83%

Section: Discussionsupporting

confidence: 79%

Clinical Profile of Children with Acute Febrile Encephalopathy in a Tertiary Health Care Center of Nepal

Sharma

Sarmah

Kayastha

et al. 2016

J. Nepal Paedtr. Soc.

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“…Similar sex prevalence ratio (M:F=1.7:1), where males were commonly involved than females in 1-5 years of age group and 6-14 years of age group, whereas males and females show equal incidence in 2 months-1year of age group was observed in a study by Karmarkar SA et al in 2008. 8 Out of 84 patients studied, 32 cases (38%) were diagnosed as viral encephalitis which was the most common etiology for febrile encephalopathy. Similar observations were found in a study by Karmarkar SA et al in 2008 which showed 37.3% of viral encephalitis cases.…”

Section: Discussionmentioning

confidence: 99%

“…8 Morbidity in relation to etiology are, out of 32 cases of viral encephalitis-persistent seizures were seen in 3 (9.3%) cases, bulbar palsy and hemiparesis in 2 (6.2%) cases each, dysarthria and cranial nerve palsy was observed in 1 (3.2%) case. Overall morbidity was 28.1% which was similar to study by Karmarkar SA et al 8 Total morbidity rate was 33.3% and out of 29 cases of pyogenic meningitis, causes of morbidity are persistent seizures which was seen in 3 (10.3%) cases; bulbar palsy, hemiparesis, dysarthria and cranial nerve palsy are seen in 1 (3.4%) case. In the same study done by Karmarkar SA et al, out of 8 cases of cerebral malaria, persistent seizures are the leading cause of morbidity which was observed in 1 (12.5%) case and out of 6 cases of Tuberculous meningitis, hydrocephalus and cranial nerve palsy are the leading causes of morbidity accounting for 1 (16.6%) case each.…”

mentioning

confidence: 99%

“…The mortality rates in the present study are comparable to a study by Karmarkar SA et al where viral encephalitis accounted to 17.5% of cases, pyogenic meningitis and brain abscess accounts for 50% each, whereas aseptic meningitis, diabetic ketoacidosis, hepatic encephalopathy, enteric encephalopathy and septicemia each showed 100% complete recovery without mortality and sequelae. 8 Morbidity in relation to etiology are, out of 32 cases of viral encephalitis-persistent seizures were seen in 3 (9.3%) cases, bulbar palsy and hemiparesis in 2 (6.2%) cases each, dysarthria and cranial nerve palsy was observed in 1 (3.2%) case. Overall morbidity was 28.1% which was similar to study by Karmarkar SA et al 8 Total morbidity rate was 33.3% and out of 29 cases of pyogenic meningitis, causes of morbidity are persistent seizures which was seen in 3 (10.3%) cases; bulbar palsy, hemiparesis, dysarthria and cranial nerve palsy are seen in 1 (3.4%) case.…”

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confidence: 99%

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Acute febrile encephalopathy and its outcome among children in a tertiary care hospital

Deepthi¹,

Vasundhara²,

P³

et al. 2018

Int J Contemp Pediatr

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Background: Acute febrile encephalopathy (AFE) is a common condition leading to hospitalization of children in India. Majority of the studies revealed etiology of AFE, but very few studies emphasized on predictors of mortality. This study was conducted to observe the outcome in relation to etiology and Glasgow coma score at admission. Methods: This prospective study was carried out on 84 children between 2 months to 14 years, with fever duration of <14 days, GCS ≤12 at the time of admission and altered sensorium in the pediatric intensive care unit over a period of 18 months (December 2011 to June 2013. Patients were evaluated daily till discharge/death. Outcome was evaluated in terms of complete recovery, morbidity and mortality. Results: In this study, AFE was higher among the age group of 6-14 years (54.7%) with most common cause being viral encephalitis (38%). Higher mortality rates were observed in CNS infections. Persistent seizures and hemiparesis were the most common causes of morbidity. GCS at initial presentation <7 was significantly associated with mortality, p value being 0.036. Conclusions: CNS infections are the leading cause of febrile encephalopathy and also associated with high mortality. Persistent seizures and hemiparesis being most common causes of morbidity. Low GCS at the time of admission and longer duration of coma are associated with higher risk of morality. Most of the morbidities were observed in CNS infections and as most of them were curable, early institution of appropriate treatment will decrease morbidity. Deepthi CHA et al. Int J Contemp Pediatr. 2018 Mar;5(2):503-507 International Journal of Contemporary Pediatrics | March-April 2018 | Vol 5 | Issue 2 Page 504 considerable skill and knowledge is required to distinguish the various groups. Majority of the studies revealed etiology of AFE, but very few studies emphasized on predictors of mortality. KeywordsThe aims and objectives of the study was to know the outcome of acute febrile encephalopathy in terms of mortality, morbidity and recovery among children aged 2months to 14 years and to evaluate outcome in relation to etiology and glasgow coma score at the time of presentation. METHODSThis prospective study was conducted on 84 children aged 2 months to 14 years who were admitted with fever and altered sensorium in the pediatric intensive care unit of ASRAM (Alluri Sitarama Raju Academy of Medical Sciences) Hospital, Eluru, over a period of 18 months (December 2011 to June 2013). Inclusion criteria• Children in the age group between 2 months to 14 years.• Children with fever of duration <14 days and GCS (modified score) of ≤12 at the time of admission.• Patients of metabolic encephalopathy if precipitated by fever. Exclusion criteria• Patients with traumatic coma.• Patients with febrile convulsions.• Patients with cerebral palsy and epilepsy.Data was collected according to the pre-structured proforma. Clinical profile was recorded at admission and patients were followed throughout the course of illness in the hospital ...

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Tropical Viral CNS Infections

Handique¹,

Barthakur

2014

CNS Infections

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A study of acute febrile encephalopathy with special reference to viral etiology

Cited by 61 publications

References 14 publications

Clinical Profile of Children with Acute Febrile Encephalopathy in a Tertiary Health Care Center of Nepal

Clinical Profile of Children with Acute Febrile Encephalopathy in a Tertiary Health Care Center of Nepal

Acute febrile encephalopathy and its outcome among children in a tertiary care hospital

Tropical Viral CNS Infections

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