Abstract
BackgroundIn China, there were few studies about the pathogens of acute viral encephalitis and meningitis in children in recent years. The aims of this study were to characterize the etiology and prognosis of acute viral encephalitis and meningitis in Chinese children.MethodsThis was a multicentre prospective study. Two hundred and sixty one viral encephalitis patients and 285 viral meningitis patients were enrolled. The mean age of viral encephalitis and meningitis were 5.88 ± 3.60 years and 6.39 ± 3.57 years, respectively. Real-time reverse transcription PCR and multiplex PCR were used to detect human enteroviruses and herpes viruses in cerebrospinal fluid (CSF) of patients with encephalitis or meningitis. The enzyme-linked immune absorbent assay (ELISA) was used for detecting IgM antibody against Japanese encephalitis virus (JEV) in CSF and against mumps virus, tick-borne encephalitis virus (TBEV), dengue virus and rubella virus in acute serum. The clinical and outcome data were collected during patients’ hospitalization.ResultsThe etiology of viral encephalitis was confirmed in 52.5% patients. The primary pathogen was human enteroviruses (27.7%) in viral encephalitis. The incidence of sequelae and the fatality rate of viral encephalitis with confirmed etiology were 7.5% and 0.8%, respectively. The etiology of viral meningitis was identified in 42.8% cases. The leading pathogen was also human enteroviruses (37.7%) in viral meningitis. The prognosis of viral meningitis was favorable with only 0.7% patients had neurological sequelae.ConclusionsHuman enteroviruses were the leading cause both in acute viral encephalitis and viral meningitis in children. The incidence of sequelae and fatality rate of viral encephalitis with confirmed etiology were 7.5% and 0.8%, respectively. The prognosis of viral meningitis was favorable compared to viral encephalitis.
Highlights
In China, there were few studies about the pathogens of acute viral encephalitis and meningitis in children in recent years
Demographic characteristics of patients Six hundred and forty two cases clinically diagnosed as viral encephalitis or viral meningitis were enrolled into this study from June 2009 to October 2012
Forty three patients were excluded according to the exclusion criteria and 53 cases were excluded for final diagnosis such as febrile convulsion, atypical purulent meningitis and so on
Summary
In China, there were few studies about the pathogens of acute viral encephalitis and meningitis in children in recent years. The aims of this study were to characterize the etiology and prognosis of acute viral encephalitis and meningitis in Chinese children. In the United States, Italy and Australia, the most commonly identified pathogen was herpes simplex virus in children and adults [2,3,4]. In Southern Vietnam, Japanese encephalitis virus (JEV) was the leading cause of viral encephalitis in children [5]. In Uttar Pradesh, India, enterovirus was an important cause of encephalitis in children [6]. Herpes simplex virus was the most commonly identified pathogen in eastern India (children and adults) [7]
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