Tripathy Sandeep Kumar, Mishra Pravakar, Dwibedi Bhagirathi, Priyadarshini Lipsa, Das Rashmi Ranjan
Department of Pediatrics, SVP Post Graduate Institute of Paediatrics, SCB Medical College, Cuttack, Odisha,, India.
Regional Medical Research Centre, Bhubaneswar, Odisha, India.
J Glob Infect Dis. 2019 Jan-Mar;11(1):7-12. doi: 10.4103/jgid.jgid_26_18.
The objective is to study the clinico-epidemiological features of viral acute encephalitis syndrome (AES) cases and compare them with nonviral AES cases in children from Eastern India.
This prospective observational study was conducted in the department of pediatrics of a tertiary care teaching hospital in Eastern India over 18-month period. Children (6 months to 15 years) with acute onset of fever (≥37.5°C) and a change in mental status (including symptoms such as confusion, disorientation, coma, or inability to talk) and/or new onset of seizures (excluding simple febrile seizures) were included in the study. The main outcome measures were the etiology and proportion attributed to viruses causing AES with clinical correlation.
Of 834 of clinically suspected AES cases, viral etiology could be confirmed in 136 (16.3%) cases (herpes simplex virus-1 [HSV-I] was most common). The 5-15 years' age group was most commonly affected (boys > girls). More cases occurred from July to November. The presence of rash and Glasgow Coma Scale <8 at admission was significantly higher in viral AES. During hospitalization, development of shock, ventilatory requirement, duration of stay, and mortality was significantly higher in viral AES. On neuroimaging, global cerebral injury was common in HSV, Japanese encephalitis, and varicella-virus AES.
Viral etiology forms a significant proportion of pediatric AES. Morbidity and mortality are high in viral compared to nonviral AES. Herpes encephalitis (HSV-I) is the most common cause of pediatric AES in Eastern India. Viral AES has poor prognosis compared to nonviral AES.
研究印度东部儿童病毒性急性脑炎综合征（AES）病例的临床流行病学特征，并与非病毒性AES病例进行比较。
这项前瞻性观察性研究在印度东部一家三级医疗教学医院的儿科进行，为期18个月。纳入研究的儿童年龄在6个月至15岁之间，有急性发热（≥37.5°C）且精神状态改变（包括意识模糊、定向障碍、昏迷或不能说话等症状）和/或新发癫痫（不包括单纯热性惊厥）。主要观察指标是病因以及与临床相关的由病毒引起AES的比例。
在834例临床疑似AES病例中，136例（16.3%）可确诊为病毒病因（单纯疱疹病毒1型[HSV-I]最为常见）。5至15岁年龄组受影响最为常见（男孩>女孩）。更多病例发生在7月至11月。病毒感染性AES患者入院时皮疹的出现和格拉斯哥昏迷量表评分<8的比例明显更高。住院期间，病毒感染性AES患者休克的发生、通气需求、住院时间和死亡率明显更高。在神经影像学检查中，HSV、日本脑炎和水痘病毒所致AES常见全脑损伤。
病毒病因在儿童AES中占相当大的比例。与非病毒性AES相比，病毒感染性AES的发病率和死亡率更高。疱疹性脑炎（HSV-I）是印度东部儿童AES最常见的病因。与非病毒性AES相比，病毒感染性AES预后较差。
