Beyond Viruses: Clinical Profiles and Etiologies Associated with Encephalitis

Glaser, Carol; Honarmand, Somayeh; Anderson, Larry J.; Schnurr, David P.; Forghani, Bagher; Cossen, Cynthia; Schuster, Frederick L.; Christie, Laura; Tureen, Jay H.

doi:10.1086/509330

Cited by 568 publications

(500 citation statements)

References 20 publications

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“…5 The prognosis is generally good, unless the host is less than 2 weeks of age or has compromised humoral immunity, which is often associated with bone marrow transplant or autoimmune disease. [4][5][6][7][8] Few data exist regarding long-term sequelae in adults with enteroviral meningoencephalitis. 6 Case reports have described an abrupt onset of enteroviral encephalitis with rapid descent into coma followed by rapid and complete neurological recovery, 9-11 although long-term cognitive sequelae have also been described.…”

Section: Discussion Of Diagnosismentioning

confidence: 99%

A case of enteroviral meningoencephalitis presenting as rapidly progressive dementia

et al. 2008

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SUMMARYBackground-A 70-year-old immunocompetent male presented to a memory disorders clinic with a 7-month illness that had begun with somatic complaints including transient right temporal head pain, left buttock pain, and right conjunctival injection. About 3 months after the first signs of illness, the patient had begun to develop insidious cognitive and behavioral decline, which progressed most rapidly in the 2 months before presentation. An assessment completed during hospitalization for intermittent fevers and confusion had not revealed an infectious etiology, although mild pleocytosis in the cerebrospinal fluid had been noted. Upon presentation to the memory disorders clinic, the patient was disoriented, distractible, laughed at inappropriate moments, and followed only one-step commands. He had hypophonic speech and had mildly increased axial tone. He scored 5 out of 30 on the Mini Mental State Examination and was admitted for expedited evaluation.

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Section: Discussion Of Diagnosismentioning

confidence: 99%

A case of enteroviral meningoencephalitis presenting as rapidly progressive dementia

et al. 2008

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“…1 Diagnosis requires evidence of neurologic dysfunction and central nervous system (CNS) inflammation. 2 Viruses are the most frequently diagnosed infectious cause of encephalitis; bacteria, fungi, and parasites are less common. 3,4 The frequency and distribution of viruses or other infectious agents causing encephalitis vary according to geographical region.…”

mentioning

confidence: 99%

Long-term Motor and Cognitive Outcome of Acute Encephalitis

Michaeli¹,

Kassis²,

Shachor-Meyouhas³

et al. 2014

Pediatrics

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WHAT'S KNOWN ON THIS SUBJECT: Encephalitis in children can cause significant neurologic sequelae, such as motor and cognitive impairment. Previous reported data are based mostly on questionnaires and clinical assessments.WHAT THIS STUDY ADDS: Significant cognitive impairment, attention-deficit/hyperactivity disorder, and learning disabilities are common after childhood encephalitis. Even children who were considered fully recovered may be significantly affected. Identifiable pathogens, abnormal neuroimaging, and abnormal neurologic examination on discharge are risk factors of poor outcome.abstract OBJECTIVES: To examine the long-term motor and neurocognitive outcome of children with acute encephalitis and to look at possible prognostic factors. METHODS:Children who were treated for acute encephalitis in 2000-2010 were reevaluated. All children and their parents were interviewed by using structured questionnaires, and the children underwent full neurologic examinations, along with comprehensive neurocognitive, attention, and behavioral assessments. RESULTS:Of the 47 children enrolled, 1 died and 29 had neurologic sequelae, including motor impairment, mental retardation, epilepsy, and attention and learning disorders. Children with encephalitis had a significantly higher prevalence of attention-deficit/hyperactivity disorder (50%) and learning disabilities (20%) compared with the reported rate (5%-10%) in the general population of Israel (P , .05) and lower IQ scores. Lower intelligence scores and significantly impaired attention and learning were found even in children who were considered fully recovered at the time of discharge. Risk factors for long-term severe neurologic sequelae were focal signs in the neurologic examination and abnormal neuroimaging on admission, confirmed infectious cause, and long hospital stay.CONCLUSIONS: Encephalitis in children may be associated with significant long-term neurologic sequelae. Significant cognitive impairment, attention-deficit/hyperactivity disorder, and learning disabilities are common, and even children who were considered fully recovered at discharge may be significantly affected. Neuropsychological testing should be recommended for survivors of childhood encephalitis.

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“…HIV testing, CSF HSV Polymerase Chain Reaction (PCR), CSF cryptococcal antigen, and Bacterial and fungal stains and cultures were negative. His serum laboratories were notable for comprehensive metabolic panel, which was within normal limits, white blood cell count 7.7 K/mm 3 . Plasma and CSF Cytomegalovirus (CMV) PCR was negative.…”

Section: Casementioning

confidence: 96%

“…Bacterial Gram stain and culture were negative. His serum laboratories were notable for comprehensive metabolic panel which was within normal limits, white blood cell count 10.9 K/mm 3 , hemoglobin 14.8 g/dL, platelets of 229 K/mm 3 . Plasma and CSF Cytomegalovirus (CMV) PCR was negative.…”

Section: Case Reports Casementioning

confidence: 99%

“…There are more than 70 subtypes of enteroviruses capable of causing human infection [1]. These viruses have a predilection for Central Nervous System (CNS) infection, and have been reported to cause over 75% of aseptic meningitis cases, and as many as 27% of infectious encephalitis cases [2,3]. The enteroviruses have also been associated with a number of other acute CNS infections, including transverse myelitis and flaccid paralysis [4,5].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Prolonged Symptoms in Solid Organ Transplant Recipients with Enteroviral Meningitis

DR¹

2013

J Infect Dis Ther

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Beyond Viruses: Clinical Profiles and Etiologies Associated with Encephalitis

Abstract: Although the etiology of encephalitis remains unknown in most cases, the recognition of discrete clinical profiles among patients with encephalitis should help focus our efforts toward understanding the etiology, pathogenesis, course, and management of this complex syndrome.

Cited by 568 publications

References 20 publications

A case of enteroviral meningoencephalitis presenting as rapidly progressive dementia

A case of enteroviral meningoencephalitis presenting as rapidly progressive dementia

Long-term Motor and Cognitive Outcome of Acute Encephalitis

Prolonged Symptoms in Solid Organ Transplant Recipients with Enteroviral Meningitis

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