Outcome and Sequelae of Infectious Encephalitis

Kvam, Kathryn A.; Stahl, Jean-Paul; Chow, Felicia C.; Soldatos, Ariane; Tattevin, Pierre; Sejvar, James; Mailles, Alexandra

doi:10.3988/jcn.2023.0240

Cited by 2 publications

(1 citation statement)

References 62 publications

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“…However, there are a few documented cases where individuals have experienced complicated forms of meningitis and/or encephalitis with lingering effects attributed to TOSV. These effects include impaired cognitive functions and altered social and sexual behaviors (60,68) Other neuroinvasive arboviruses, such as WNV, JEV or TBEV, cause long-lasting or permanent sequelae (75).…”

Section: Discussionmentioning

confidence: 99%

Toscana Virus Infection Clinical Characterization

Ayhan,

Eldin,

Charrel

2024

Preprint

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Background: Toscana virus (TOSV) is a sandfly-borne phlebovirus causing central nervous system (CNS) infection in Mediterranean countries, during summer season. However, clinical aspects of the disease caused by this virus are poorly known by clinicians, so that its prevalence is probably underestimated due to a lack of diagnosis. Study design: We gathered data from all available case series and retrospective studies identifying TOSV as the causative viral agent. The informations of age, sex, clinical characteristics, laboratory ﬁndings, imaging results and clinical outcomes of TOSV infection were recorded and analyzed. Results: In our review a total of 95 articles including TOSV infections resulting in a total of 1,381 cases were analyzed. Our findings indicate, TOSV affects individuals across various age groups, with a median age of 44.45 years. A notable disparity in infection rates between genders, with men being significantly more likely to present symptoms due to TOSV than women, with a sex ratio of 2.0 (p<0.001). The clinical presentation of TOSV infection encompasses a range of symptoms, including fever, headache, retro-orbital pain, neurological and muscular manifestations with less common reports of cutaneous and gastrointestinal symptoms. To date, six fatalities have been attributed to TOSV infections, with a median age of 76 years. Diagnostic evaluation of TOSV infections often involves the analysis of cerebrospinal fluid, where findings may include an elevated white blood cell count. Conclusions: These findings underscore the diverse clinical manifestations of TOSV infections and highlight the importance of considering this pathogen in the differential diagnosis of patients presenting with acute febrile illness, especially in endemic regions. TOSV represents an emerging infectious threat that warrants inclusion in the diagnostic protocols for patients presenting with CNS, particularly within the Mediterranean basin or for those with recent travel history to endemic regions during warmer months when sandflies are actively circulating.

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Section: Discussionmentioning

confidence: 99%

Toscana Virus Infection Clinical Characterization

Ayhan,

Eldin,

Charrel

2024

Preprint

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Outcome and Sequelae of Autoimmune Encephalitis

Kvam,

Stahl,

Chow

et al. 2024

J Clin Neurol

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Autoimmune etiologies are a common cause for encephalitis. The clinical syndromes consistent with autoimmune encephalitis are both distinct and increasingly recognized, but less is known about persisting sequelae or outcomes. We searched PubMed for reports on outcomes after autoimmune encephalitis. Studies assessing validated, quantitative outcomes were included. We performed a narrative review of the published literature of outcomes after autoimmune encephalitis. We found 146 studies that produced outcomes data. The mortality rates were 6%–19% and the relapse risks were 10%–62%. Most patients achieved a good outcome based on a score on the modified Rankin Scale (mRS) of ≤2. Forty-nine studies evaluated outcomes beyond mRS; these studies investigated cognitive outcome, psychiatric sequelae, neurological deficits, global function, and quality-of-life/patient-reported outcomes using various tools at varying time points after the index hospital discharge. These more-detailed assessments revealed that most patients had persistent impairments, with frequent deficits in cognitive function, especially memory and attention. Depression and anxiety were also common. Many of these sequelae continued to improve over months or even years after the acute illness. While we found that lasting impairments were common among survivors of autoimmune encephalitis, additional research is needed to better understand the nature and impact of these sequelae. Standardized evaluation protocols are needed to improve the ability to compare outcomes across studies, guide rehabilitation strategies, and inform outcomes of interest in treatment trials as the field advances.

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Outcome and Sequelae of Infectious Encephalitis

Cited by 2 publications

References 62 publications

Toscana Virus Infection Clinical Characterization

Toscana Virus Infection Clinical Characterization

Outcome and Sequelae of Autoimmune Encephalitis

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