Epidemiological Profile of Acute Viral Encephalitis in a Sample of Egyptian Children

Abstract

INTRODUCTION:Acute encephalitis syndrome (AES) is a considerable public health problem.AIM:This study was designed to describe the aetiology, demographic features, clinical picture, short-term outcome and risk factors of mortality of children with viral encephalitis in Egyptian children.METHODS:PCR detection of viruses in the CSF of pediatric patients admitted to the pediatric unit or ICU Cairo University Pediatric hospital presenting with encephalitis syndrome.RESULTS:Of the 96 patients included in the study, viral etiological agents were detected in 20 cases (20.8%), while 76 patients (79.2%) had no definite viral aetiology. The most abundant virus detected was Enterovirus (EV) in fourteen (14.5%), two (2.1%) were positive for human herpes simplex virus 6 (HSV-6), one (1.0%), human herpes simplex virus1 (HSV-1), one (1.0%) Epstein Barr virus (EBV), one (1.0%), cytomegalovirus (CMV) and one (1.0%) with varicella-zoster virus (VZV). On the short term outcome, 22 (22.9) patients died, and 74 (77.1%) survived. Severity outcome among survival was vegetative in three cases (4%) severe in 9 (12.16%), moderate in 14 (18.9%), mild in 29 (39.2%) and full recovery in 19 (25.6%). Mortality risk factors for younger age, the presence of apnea, the need for mechanical ventilation and the presence of abnormal CT findings were all significantly associated with fatal outcome (p < 0.05).CONCLUSION:Enterovirus was the most common cause of encephalitis among Egyptian children. Mortality was correlated with younger age and disease severity at admission. Sequelae were high among infected children.

Incidence of Encephalitis in the Intensive Care Unit, a Tertiary Care Hospital, Pakistan: A 5-Year Retrospective Study

“…In our study, an estimated length of stay of patients with encephalitis in the intensive care unit was 5.45±2.62 days. In comparison to our study, Sonneville et al ( 20 ) in 2015 also concluded that the duration of stay in the intensive care unit was estimated to be 9 days (5–22 days).…”

“…According to the study conducted by Sonneville et al ( 4 ), 42 % patients with encephalitis need mechanical ventilation at the time of admission, and 13% of patients needs mechanical ventilation thereafter. In another study conducted on children with encephalitis, 44.8% patients required mechanical ventilation ( 20 ). In 2017, a study was conducted in India which concluded that 42% patients with encephalitis need invasive ventilation ( 21 ).…”

A Study on Clinical Features, Aetiology, Outcomes and Predictors of Mortality and Morbidity in Children With Acute Encephalitis Syndrome in Eastern India

“…Kirti Gupta et al (2) showed that GCS < 8, shock, raised intracranial tension and respiratory failure were the risk factors associated with higher mortality. Meligy and his colleagues in Egypt in 2018 (10) showed mechanical ventilation was a risk factor for fatality.…”

Infeksi Susunan Saraf Pusat pada Anak: Sebuah Studi Potong Lintang Deskriptif Selama Lima Tahun

“…Satu penelitian juga menunjukkan mayoritas pasien ensefalitis adalah laki-laki. 2 Infeksi HIV dapat menjadi faktor risiko, meningkatkan mortalitas, memperburuk prognosis, dan memengaruhi keberhasilan terapi pada infeksi SSP. 21,22 Prevalensi pasien yang tidak mengetahui status imunisasi BCG masih cukup tinggi, yaitu 21,4 % pada pasien meningitis TB dan 33,3% pada pasien meningoensefalitis.…”

“…Terdapat literatur yang menyatakan bahwa pasien dengan ensefalitis viral rata-rata terjadi pada usia 29 bulan. 2 Awitan gejala meningitis TB pada anak cenderung beragam sesuai dengan hasil penelitian. Mayoritas memiliki awitan sub-akut, hal ini disebabkan oleh gejala awal yang sering menyerupai penyakit lain sehingga mempersulit diagnosis.…”