Kolski H, Ford-Jones E L, Richardson S, Petric M, Nelson S, Jamieson F, Blaser S, Gold R, Otsubo H, Heurter H, MacGregor D
Department of Pediatrics, The Hospital for Sick Children and the University of Toronto, Ontario, Canada.
Clin Infect Dis. 1998 Feb;26(2):398-409. doi: 10.1086/516301.
Of 145 patients admitted to our hospital because of encephalitis-like illness, 50 patients hospitalized for > or =72 hours underwent standardized microbiological investigations. A confirmed or probable etiologic agent was identified in 20 cases (40%), including Mycoplasma pneumoniae (9 cases). M. pneumoniae and enterovirus (2), herpes simplex virus (4), Epstein-Barr virus (1), human herpes-virus 6 (HHV-6) (1), HHV-6 and influenza virus type A (1), influenza virus type A (1), and Powassan virus (1). In 13 cases (26%), a possible pathogen was identified, including M. pneumoniae in nine cases. Presenting features included fever (80% of patients), seizures (78%), focal neurological findings (78%), and decreased consciousness (47%). The frequency of findings at the time of admission vs. later in hospitalization was as follows: pleocytosis, 59% vs. 63%; electroencephalogram abnormalities, 87% vs. 96%; and neuroimaging abnormalities, 37% vs. 69%, respectively. The outcomes at the time of discharge were as follows: normal results of physical examination, 32% (16) of the patients; death, 2% (1); motor difficulties, 26% (13); global neurological deficits, 16% (severe, 6; mild, 2); mental status changes, 14% (7); visual defects, 8% (4); and hearing impairment, 2% (1).
在因类脑炎疾病入住我院的145例患者中，50例住院时间≥72小时的患者接受了标准化微生物学检查。20例（40%）患者确定了确诊或可能的病原体，包括肺炎支原体（9例）。肺炎支原体和肠道病毒（2例）、单纯疱疹病毒（4例）、EB病毒（1例）、人疱疹病毒6型（HHV-6）（1例）、HHV-6和甲型流感病毒（1例）、甲型流感病毒（1例）以及波瓦桑病毒（1例）。13例（26%）患者确定了可能的病原体，其中9例为肺炎支原体。临床表现包括发热（80%的患者）、癫痫发作（78%）、局灶性神经学表现（78%）和意识减退（47%）。入院时与住院后期的检查结果频率如下：脑脊液细胞增多分别为59%和63%；脑电图异常分别为87%和96%；神经影像学异常分别为37%和69%。出院时的结果如下：体格检查结果正常的患者占32%（16例）；死亡2%（1例）；运动困难26%（13例）；全面神经功能缺损16%（重度6例；轻度2例）；精神状态改变14%（7例）；视力缺陷8%（4例）；听力障碍2%（1例）。
