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法属圭亚那脑炎的临床特征、诊断和转归。

Clinical Features, Diagnosis, and Outcome of Encephalitis in French Guiana.

机构信息

Intensive Care Unit, Cayenne General Hospital, Cayenne, French Guiana.

Regional Authority of Health, Cayenne, French Guiana.

出版信息

Am J Trop Med Hyg. 2019 Feb;100(2):452-459. doi: 10.4269/ajtmh.18-0308.

Abstract

The aim of our study was to describe the clinical features, the etiologies, and the factors associated with poor outcome of encephalitis in French Guiana. Our study was retrospective, including all cases of encephalitis hospitalized in the Cayenne General Hospital, from January 2007 to July 2017. Patients were included through the 2013 encephalitis consortium criteria and the outcome was evaluated using the Glasgow outcome scale at 3 months from the diagnosis of encephalitis. We included 108 patients, giving an approximate incidence rate of four cases/100,000 inhabitants/year. The origin of the encephalitis was diagnosed in 81 cases (75%), and 72 of them (66.7%) were from an infectious origin. The most common infectious causes were sp. (18.5%) independently of the immune status, (13.9%), and (5.5%). In the follow-up, 48 patients (46.6%) had poor outcome. Independent risk factors associated with poor outcome at 3 months were "coming from inside area of the region" ( = 0.036, odds ratio [OR] = 4.19; CI 95% = 1.09-16.06), need for mechanical ventilation ( = 0.002, OR = 5.92; CI 95% = 1.95-17.95), and age ≥ 65 years ( = 0.049, OR = 3.99; CI 95% = 1.01-15.89). The most identified cause of encephalitis in French Guiana was . The shape of the local epidemiology highlights the original infectious situation with some local specific pathogens.

摘要

我们的研究目的是描述法属圭亚那脑炎的临床特征、病因学以及与不良预后相关的因素。我们的研究是回顾性的,纳入了 2007 年 1 月至 2017 年 7 月期间在卡宴总医院住院的所有脑炎患者。患者的纳入标准是根据 2013 年脑炎协作组的标准,使用格拉斯哥预后量表在脑炎确诊后 3 个月评估预后。我们共纳入了 108 例患者,估计发病率为每 10 万人每年 4 例。81 例(75%)患者的脑炎病因得到诊断,其中 72 例(66.7%)为感染性病因。最常见的感染性病因是 sp.(18.5%),独立于免疫状态, (13.9%)和 (5.5%)。随访时,48 例患者(46.6%)预后不良。3 个月时预后不良的独立危险因素包括“来自地区内部”( = 0.036,优势比 [OR] = 4.19;95%置信区间 [CI] = 1.09-16.06)、需要机械通气( = 0.002,OR = 5.92;95%CI = 1.95-17.95)和年龄≥65 岁( = 0.049,OR = 3.99;95%CI = 1.01-15.89)。法属圭亚那脑炎最常见的病因是 sp.。当地流行病学的特征突出了具有一些当地特定病原体的原始感染情况。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ebec/6367637/bde833954f5d/tpmd180308f1.jpg

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