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儿童流感相关性脑病:来自意大利北部一家三级医院的流行病学及文献综述(2023 - 2024年冬季)

Influenza-Related Encephalopathy in Children: Epidemiology and Literature Review from a Tertiary Hospital in Northern Italy (Winter 2023-2024).

作者信息

Vitale Raffaele, Denina Marco, Badiali Laura, Sandei Matteo, Mazzetti Giulia, Canavese Carlotta, Tocchet Aba, Versace Antonia, Garazzino Silvia

机构信息

Infectious Diseases Unit, Department of Pediatrics, Regina Margherita Children's Hospital, A.O.U. Città Della Salute e Della Scienza di Torino, 10126 Turin, Italy.

Department of Public Health and Pediatrics, Università Degli Studi di Torino, Piazza Polonia 94, 10126 Turin, Italy.

出版信息

Pathogens. 2025 Jun 1;14(6):551. doi: 10.3390/pathogens14060551.

Abstract

INTRODUCTION

While influenza-associated encephalopathy (IAE) in children remains a serious concern, recent evidence suggests a shift in its epidemiology, with a possible decline in incidence and severity over time.

METHODS

This retrospective review includes patients aged 0-18 admitted to a tertiary hospital in Northern Italy between November 2023 and February 2025. Inclusion criteria were a positive influenza test, influenza-like symptoms, and neurological involvement. Findings are interpreted alongside current literature.

RESULTS

Twenty-five unvaccinated children met criteria for IAE (11 in 2023/24; 14 in 2024/25). Neurological comorbidities were present in 40%. All patients had pathological EEGs. Lumbar puncture was performed in 40%, with abnormalities in 33%. Brain imaging was conducted in 56% of cases, revealing findings in 15%. All received oseltamivir; 60% were also treated with dexamethasone. Severe complications occurred in 16%, while 12% had persistent symptoms or required therapy at discharge. After adjusting for seasonal peak timing, no significant inter-seasonal difference was observed.

DISCUSSION

Although IAE continues to present serious risks, recent trends suggest a changing burden. The lack of vaccination among cases underscores the need for prevention. Study limitations include its single-center design and the absence of long-term follow-up. Broader prospective studies are needed.

摘要

引言

尽管儿童流感相关性脑病(IAE)仍然是一个严重问题,但最近的证据表明其流行病学发生了变化,发病率和严重程度可能随时间下降。

方法

这项回顾性研究纳入了2023年11月至2025年2月期间入住意大利北部一家三级医院的0至18岁患者。纳入标准为流感检测呈阳性、流感样症状和神经系统受累。研究结果结合当前文献进行解读。

结果

25名未接种疫苗的儿童符合IAE标准(2023/24年度11例;2024/25年度14例)。40%的患者存在神经合并症。所有患者脑电图均异常。40%的患者进行了腰椎穿刺,其中33%存在异常。56%的病例进行了脑部成像,15%有阳性发现。所有患者均接受了奥司他韦治疗;60%的患者还接受了地塞米松治疗。16%的患者出现严重并发症,12%的患者出院时仍有持续症状或需要治疗。在调整季节性高峰时间后,未观察到显著的季节间差异。

讨论

尽管IAE仍然存在严重风险,但最近的趋势表明负担在变化。病例中未接种疫苗的情况凸显了预防的必要性。研究局限性包括单中心设计和缺乏长期随访。需要更广泛的前瞻性研究。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8e1f/12196207/cf00aef82bc5/pathogens-14-00551-g001.jpg

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