A Study on Etiological Profile in Adults With Acute Febrile Encephalopathy in a Tertiary Care Centre in Eastern India

Abstract

Background: Acute febrile encephalopathy is a common clinical syndrome across the globe with the principal cause and manifestations differing according to the demographics. In developing nations like India primary central nervous system infections is the chief culprit.
 Aim: To identify the etiology of acute febrile encephalopathy and to document the clinical manifestations on presentation. The patients were followed up till discharge and outcome was analyzed in relation with etiology.
 Materials & Methods: This observational prospective study was done among 50 patients presenting with fever and altered mental status. History, clinical examination, biochemical investigations including cerebrospinal fluid analysis and neuroimaging was done to diagnose the cases individually. The statistical software SPSS version 2.0 was used for the analysis Categorical variables were expressed as number of patients or percentage of patients and compared across the groups using Pearson’s Chi Square test for independence of attributes. Continuous variables was expressed as mean and standard deviation and compared across the groups using Kruskal Wallis Test. An alpha level of 5% was taken, i.e. if any p value is less than 0.05 it was considered as significant.
 Results: Out of these 50 patients 70% were due to CNS infections among which viral meningoencephalitis were the commonest cause. The other causes were leptospirosis, brain abscess, cerebral malaria, sepsis associated encephalopathy, acute disseminated encephalomyelitis, neuroleptic malignant syndrome. 14% of patients had sepsis associated encephalopathy and these patients had the highest mortality
 Conclusion: Acute febrile encephalopathy is a clinically heterogeneous syndrome with a number of causes. It is an important public health issue due to its steep mortality rate.
 Keywords: acute febrile encephalopathy, meningoencephalitis, mortality, sepsis associated encephalopathy

Clinical and Etiological Spectrum of Acute Febrile Encephalopathy in Adult Patients: A Propspective Study From Odisha, India

“…In our study, we have observed a male preponderance and likewise in a study done by Peidaee et al, [6] 60.8% were males and 39.2% were females with a male to female ratio of 1.54. Similarly in another research, reported by Sen et al, [7] in India 64% were males and 36% were females. Although no CNS infections are identified to require predilection toward every gender and the male preponderance in the present study might be due to male subjugated social organization with male getting privileged medical consideration.…”

“…Likewise, in a study done by Bhalla et al, [2] 42 patients had meningitis and among these 32 (25.2%) had acute pyogenic meningitis (APM) and 10 (7.87%) had TBM. In another study done by Sen et al, [7] the major etiology was viral meningoencephalitis in 30% of the cases, followed by APM in 22% of cases, CM in 10% of the cases and SAE in 14% of the patients.…”