Herpes Simplex Virus Encephalitis in Geriatric Patients

Sili, Uluhan; Tavşanlı, Mustafa Emir; Tufan, Aslı

doi:10.1007/s13670-017-0198-9

Cited by 3 publications

(1 citation statement)

References 58 publications

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“…Our findings outline the difficulties to diagnose encephalitis in elderly patients, as i) cardinal signs, such as fever, are usually absent; ii) confusion or delirium in the elderlies may be triggered by many other mechanisms, including metabolic, neoplastic, vascular, septic, or toxic pathways. Central nervous system infections, including encephalitis, may be mistaken for many other diseases, and this is especially true in the elderlies, for whom the diagnosis of encephalitis is particularly challenging [33] [34]. Nevertheless, in our study, time from symptoms onset to aciclovir treatment start was similar across all age groups.…”

Section: Discussionmentioning

confidence: 54%

Infectious encephalitis in elderly patients: a prospective multicentre observational study in France 2016–2019

Petitgas

Abgrall²,

Argaud³

et al. 2022

Infection

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Purpose. Data on encephalitis in the elderly remain scarce. We aimed to describe the characteristics, aetiologies, management, and outcome of encephalitis in patients older than 65 years. Methods.We performed an ancillary study of ENCEIF, a prospective cohort that enrolled all cases of encephalitis managed in 46 clinical sites in France during years 2016-2019. Cases were categorized in 3 age groups: i) 18-64; ii) 65-79; iii) ≥80 years.Results. Of the 494 adults with encephalitis enrolled, 258 (52%) were ≥65 years, including 74 (15%) ≥80 years. Patients ≥65 years were more likely to present with coma, impaired consciousness, confusion, aphasia, and rash, but less likely to present with fever, and headache (P<0.05 for each). Median cerebrospinal fluid (CSF) white cells count was 61/mm 3 [13-220] in 65-79 years, 62 [17-180] in ≥80 years, vs. 114 [34-302] in <65 years (P=0.01). The proportion of cases due to Listeria monocytogenes and VZV increased after 65 years (P<0.001), while the proportion of tick-borne encephalitis and Mycobacterium tuberculosis decreased with age (P<0.05 for each).In-hospital mortality was 6/234 (3%) in <65 years, 18/183 (10%) in 65-79 years, and 13/73 (18%) in ≥80 years (P<0.001). Age ≥80 years, coma on admission, CSF protein ≥0.8 g/L and viral encephalitis were independently predictive of 6-month mortality. Conclusion.The elderlies represent >50% of adult patients with encephalitis in France, with higher proportion of L. monocytogenes and VZV encephalitis, increased risk of death, and sequels. The empirical treatment currently recommended, aciclovir and amoxicillin, is appropriate for this age group.

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Section: Discussionmentioning

confidence: 54%

Infectious encephalitis in elderly patients: a prospective multicentre observational study in France 2016–2019

Petitgas

Abgrall²,

Argaud³

et al. 2022

Infection

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A felnőttkori neuroinfekciók epidemiológiai és klinikai jellemzőinek vizsgálata a nyugat-dunántúli régióban

2019

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Introduction: Despite advancements in diagnostic capabilities and the availability of effective antimicrobial agents, community-acquired infections of the central nervous system (CNS) are still associated with high mortality rates. Aim: To assess the epidemiological and clinical characteristics of community-acquired CNS infections treated in the West Pannonian region between 2010 and 2016. Method: Clinical data of 176 patients were retrospectively analysed in two age cohorts: 15 to 65 and more than 65 years of age. Results: Neuroinfections were found to be bacterial in 81, viral in 91, parasitic in 1 and mixed in 3 cases during the observation period. The most frequent bacterial pathogens isolated were Streptococcus pneumoniae (20%) and Borrelia burgdorferi (16%). The most frequent viral pathogens isolated were tick-borne encephalitis virus (37%), herpes simplex virus (10%) and enterovirus (7%). Aetiology was unknown in 40 percent of all cases. The average incidence rate was 9.8/100 000 person/year with a mortality rate of 12%. In the cohort of patients aged >65 years, significantly higher frequencies of immunocompromising factors, lower Glasgow Coma Scale values at admission and confusion were observed (p-values: 0.008, 0.017, and 0.050, respectively). Prognosis was negatively influenced by low Glasgow Coma Scale values at admission (OR = 1.6 CI95%: 1.3–1.9; p<0.001), old age (OR = 6.5 CI95%: 2.5–17.1; p<0.001) and immunodeficiency (OR = 3.1 CI95%: 1.2–8.1; p = 0.019). Conclusions: S. pneumoniae remains the most frequently observed causative bacterial pathogen associated with community-acquired CNS infections. Incidence of tick-borne encephalitis in our county is higher than the national average (2.3 versus 0.35/100 000 person/year). Orv Hetil. 2019; 160(40): 1574–1583.

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An autopsy case of elderly-onset herpes simplex encephalitis with acute respiratory failure caused by brainstem lesions

et al. 2020

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Herpes Simplex Virus Encephalitis in Geriatric Patients

Cited by 3 publications

References 58 publications

Infectious encephalitis in elderly patients: a prospective multicentre observational study in France 2016–2019

Infectious encephalitis in elderly patients: a prospective multicentre observational study in France 2016–2019

A felnőttkori neuroinfekciók epidemiológiai és klinikai jellemzőinek vizsgálata a nyugat-dunántúli régióban

An autopsy case of elderly-onset herpes simplex encephalitis with acute respiratory failure caused by brainstem lesions

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