Institute for Infectious Diseases, University of Bern, Bern, Switzerland.
Clin Microbiol Infect. 2011 Apr;17(4):621-6. doi: 10.1111/j.1469-0691.2010.03276.x.
Encephalitis is caused by a variety of conditions, including infections of the brain by a wide range of pathogens. A substantial number of cases of encephalitis defy all attempts at identifying a specific cause. Little is known about the long-term prognosis in patients with encephalitis of unknown aetiology, which complicates their management during the acute illness. To learn more about the prognosis of patients with encephalitis of unknown aetiology, patients in whom no aetiology could be identified were examined in a large, single-centre encephalitis cohort. In addition to analysing the clinical data of the acute illness, surviving patients were assessed by telephone interview a minimum of 2 years after the acute illness by applying a standardized test battery. Of the patients with encephalitis who qualified for inclusion (n = 203), 39 patients (19.2%) had encephalitis of unknown aetiology. The case fatality in these patients was 12.8%. Among the survivors, 53% suffered from various neurological sequelae, most often attention and sensory deficits. Among the features at presentation that were associated with adverse outcome were older age, increased C-reactive protein, coma and a high percentage of polymorphonuclear cells in the cerebrospinal fluid. In conclusion, the outcome in an unselected cohort of patients with encephalitis of unknown aetiology was marked by substantial case fatality and by long-term neurological deficits in approximately one-half of the surviving patients. Certain features on admission predicted an unfavourable outcome.
脑炎由多种情况引起，包括各种病原体对大脑的感染。大量脑炎病例经各种尝试仍无法确定具体病因。对于病因不明的脑炎患者的长期预后知之甚少，这使得在急性疾病期间对其进行管理变得复杂。为了更多地了解病因不明的脑炎患者的预后，在一项大型单中心脑炎队列中对未能确定病因的患者进行了检查。除了分析急性疾病的临床数据外，对存活患者在急性疾病后至少 2 年通过应用标准化测试套件进行电话访谈进行评估。在有资格纳入的脑炎患者中（n=203），39 名患者（19.2%）患有病因不明的脑炎。这些患者的病死率为 12.8%。在幸存者中，53%患有各种神经后遗症，最常见的是注意力和感觉缺陷。与不良预后相关的特征包括年龄较大、C 反应蛋白增加、昏迷和脑脊液中多形核细胞比例高。总之，在病因不明的脑炎患者的未选择队列中，结果表现为相当高的病死率和大约一半存活患者存在长期神经功能缺陷。入院时的某些特征预示着预后不良。
