Abstract
BackgroundDetermining the etiology of encephalitis always remains a challenge to clinicians, and also, variables that predict outcome in acute phase settings are not known precisely. The autoimmune causes of acute encephalitis are increasing due to the availability of newer diagnostic markers, whereas earlier studies were primarily focused on infectious causes. We conducted a prospective study to determine the demographic profile, etiological aspect, and in-hospital outcome of patients admitted with acute encephalitis syndrome (AES) in our tertiary care center.Materials and methodThis observational prospective study was carried out at a tertiary care hospital between November 2016 and October 2018. With a sample size of 72, appropriate statistical analysis was done.ResultsThe incidence of AES usually escalates during the rainy season, with arboviral etiologies being predominant. The majority of the patients with AES with a likely infectious etiology could not be diagnosed with presently available viral marker studies. Among various clinical variables, a low Glasgow Coma Scale (GCS) score on admission, a high CSF protein value, and diffusion restriction on brain MRI was associated with poor outcome.ConclusionAcute encephalitis and encephalitis-related mortality impose a considerable burden on current medical practice. The reported demographics of hospitalized patients with encephalitis may be changing, which are important factors to consider for etiological workup.
Highlights
Acute encephalitis is a challenging syndrome worldwide to diagnose and manage given the heterogeneity of clinical presentations and the myriad of causative agents
The incidence of acute encephalitis syndrome (AES) usually escalates during the rainy season, with arboviral etiologies being predominant
A low Glasgow Coma Scale (GCS) score on admission, a high CSF protein value, and diffusion restriction on brain MRI was associated with poor outcome
Summary
Acute encephalitis is a challenging syndrome worldwide to diagnose and manage given the heterogeneity of clinical presentations and the myriad of causative agents. Numerous advances have uncovered novel infectious and autoimmune etiologies of encephalitis [1]. Despite such advances, in large studies, more than 50% of encephalitis cases typically remain without an identified etiology, posing additional challenges in delivering prognosis and treatment [1]. Steady deterioration in sensorium without fever and the absence of CSF leukocytosis is a common presentation of encephalopathy [3]. Determining the etiology of encephalitis always remains a challenge to clinicians, and variables that predict outcome in acute phase settings are not known precisely. We conducted a prospective study to determine the demographic profile, etiological aspect, and in-hospital outcome of patients admitted with acute encephalitis syndrome (AES) in our tertiary care center
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