scholarly journals Comment on “Clinical Profile and Outcome of Japanese Encephalitis in Children Admitted with Acute Encephalitis Syndrome”

2014 ◽  
Vol 2014 ◽  
pp. 1-1
Author(s):  
Girish Chandra Bhatt ◽  
Tanya Sharma
Keyword(s):  
Japanese Encephalitis ◽  
Clinical Profile ◽  
Acute Encephalitis Syndrome ◽  
Acute Encephalitis

scholarly journals Clinical Profile and Outcome of Japanese Encephalitis in Children Admitted with Acute Encephalitis Syndrome

2013 ◽  
Vol 2013 ◽  
pp. 1-5 ◽  
Author(s):  
Gitali Kakoti ◽  
Prafulla Dutta ◽  
Bishnu Ram Das ◽  
Jani Borah ◽  
Jagadish Mahanta
Keyword(s):  
Japanese Encephalitis ◽  
Viral Disease ◽  
Clinical Profile ◽  
College Hospital ◽  
Meningeal Irritation ◽  
Medical College ◽  
Presenting Symptoms ◽  
Acute Encephalitis Syndrome ◽  
Acute Encephalitis ◽  
A Prospective Study

Japanese encephalitis (JE) is an arthropod borne viral disease. Children are most commonly affected in Southeast Asian region showing symptoms of central nervous system with several complications and death. The clinical characteristics and outcomes in pediatric JE patients hospitalized with acute encephalitis syndrome (AES) are still poorly understood. A prospective study was conducted in pediatric ward of Assam Medical College Hospital to evaluate the clinical profile and outcome of JE in children. A total of 223 hospitalized AES cases were enrolled during March to December 2012. Serum and cerebro spinal fluids were tested for presence of JE specific IgM antibody. 67 (30%) were found to be JE positive. The most common presenting symptoms in JE patients were fever (100%), altered sensorium (83.58%), seizure (82.08%), headache (41.79%), and vomiting (29.85%). Signs of meningeal irritation were present in 55.22% of cases. Around 40.29%, JE patients had GCS ≤ 8. Among the JE patients, 14.7% died before discharge. The complete recoveries were observed in 63.9% of cases, while 21.3% had some sort of disability at the time of discharge. JE is still a major cause of AES in children in this part of India. These significant findings thus seek attentions of the global community to combat JE in children.

scholarly journals Clinical profile and outcome of acute encephalitis syndrome (AES) patients treated in College of Medical Sciences-Teaching Hospital

2014 ◽  
Vol 9 (2) ◽  
pp. 31-37
Author(s):  
Lekhjung J Thapa ◽  
RS Twayana ◽  
R Shilpakar ◽  
MR Ghimire ◽  
A Shrestha ◽  
...  
Keyword(s):  
Japanese Encephalitis Virus ◽  
Japanese Encephalitis ◽  
Teaching Hospital ◽  
Tertiary Care ◽  
Encephalitis Virus ◽  
Clinical Profile ◽  
Major Public Health Problem ◽  
Medical Sciences ◽  
Acute Encephalitis Syndrome ◽  
Acute Encephalitis

Objective: Acute encephalitis syndrome is a cause of significant morbidity and mortality in Nepal. Although Japanese encephalitis virus (JEV) was thought to be a major cause for acute encephalitis syndrome, more non-Japanese encephalitis virus cases are reported. The outcome of patients with acute encephalitis syndrome is variable. Our study was designed to study the clinical profile and outcome of patients with acute encephalitis syndrome managed in tertiary care center in central Nepal. Methods: The record of patients admitted with diagnosis of acute encephalitis syndrome,from January 2010 to December 2010 in College of Medical Sciences-Teaching Hospital (CMS-TH) was reviewed. They were classified clinically as meningitis, encephalitis and meningoencephalitis. The clinical details and reports of the patients were recorded and analyzed. Results: Total of 85 cases of meningitis and encephalitis were identified. Mean age was 19.18 years. Fifty-six (65.9%) patients were males and 29 (34.1%) were females. Sixty (70.58%) patients had meningitis, 8 (9.41%) had encephalitis, and 17 (20.0%) had meningoencephalitis. JE serology was positive in 4 patients (4.7%). Seventy-two (84.7%) patients made full recovery and were discharged from hospital. Thirteen (15.3%) patients left against medical advice (LAMA). Conclusion: Acute encephalitis syndrome is still a major public health problem in Nepal. Few of these patients have Japanese Encephalitis. There is a trend towards improved outcome because of availability of improved health services. However, financial constraint remains a challenge in management of acute encephalitis syndrome. Journal of College of Medical Sciences-Nepal, 2013, Vol-9, No-2, 31-37 DOI: http://dx.doi.org/10.3126/jcmsn.v9i2.9685

scholarly journals Clinical profile and predictors of outcome in children admitted to PICU with acute encephalitis syndrome

2017 ◽  
Vol 4 (4) ◽  
pp. 1214 ◽  
Author(s):  
Ekambaranath Sambasivam ◽  
Jayakumar Muthaiyan ◽  
Sreedivya Mohan ◽  
Aravind Malayappan Ayyavoo ◽  
Ganesh Jayachandran
Keyword(s):  
Tamil Nadu ◽  
Case Fatality ◽  
Unknown Origin ◽  
Clinical Profile ◽  
Prognostic Indicators ◽  
Predictors Of Outcome ◽  
Diagnostic Challenge ◽  
Female Ratio ◽  
Acute Encephalitis Syndrome ◽  
Acute Encephalitis

Background: Acute encephalitis syndrome (AES) is defined as the acute onset of fever and change in mental status (including symptoms such as confusion, disorientation, coma or inability to talk) and/or new onset seizures (excluding febrile seizures) in a person of any age at any time of the year. AES is reported mainly from Assam, Bihar, Tamil Nadu, Karnataka, Uttar Pradesh contributing approximately to 80% cases with case fatality rate of 20-25%. In view of paucity of clinical studies from Tamil Nadu, this study was undertaken to have a better insight on the clinical profile and prognostic indicators of AES in children. Objective of present work was to study the clinical profile and predictors of outcome of Acute encephalitis syndrome patients admitted in PICUMethods: This retrospective study was conducted in children with AES admitted to PICU, Stanley medical college over a period of 1year (May 2015-May 2016). 30 cases were studied. Clinical features, demography, immunisation status, and outcome were recorded. Results of blood investigations, peripheral smear, neuroimaging, CSF analysis and IgM ELISA for HSV, JE, CMV, Dengue were recorded and analysed.Results: Mean age of cases was 3.5±3.3years. Male to female ratio was 1.1:1. Etiology included HSV (6.67%), malaria (3.33%), dengue (3.33%), tubercular meningitis (3.33%), AES of unknown origin (83.3%) 11, Most common presentation was seizures 21 (70%). 17 (56.6%)presented with GCS <8. 11 (36.6%) required inotrope support, 16 (53.4%) were ventilated. Laboratorial findings included, leukocytosis in 17 (66.7%), dysglycemia in 12 children (39.99%), hyponatremia in 10 (33.33%), hypernatremia in 8 (26.67%) Mortality was observed in 11 cases (36.67%). Hyponatremia (p=0.02) and cases requiring ionotrope support on admission (p=0.0003) were significantly associated with mortality.Conclusions: There was no case of Japanese encephalitis. Hyponatremia being significantly associated with mortality among children with AES, warrants detailed evaluation to define the etiology which will aid in appropriate management. Maintaining euvolemia, prompt identification of shock and appropriate use of inotropes is of utmost importance. Varied and changing etiologies of AES poses a diagnostic challenge. 

Status and trend of acute encephalitis syndrome and Japanese encephalitis in Bihar, India

2017 ◽  
Vol 30 (6) ◽  
pp. 317 ◽  
Author(s):  
PM Pisudde ◽  
Praveen Kumar ◽  
PP Sarthi ◽  
MP Sharma ◽  
VR Keshri
Keyword(s):  
Japanese Encephalitis ◽  
Acute Encephalitis Syndrome ◽  
Acute Encephalitis

A study on epidemiological pattern of acute encephalitis syndrome with special reference to japanese encephalitis in Patna medical college and hospital, Patna, Bihar, India

2017 ◽  
Vol 4 (4) ◽  
pp. 1210
Author(s):  
Anil Kumar Tiwari ◽  
Anil Kumar Jaiswal ◽  
Tauhid Iqbali
Keyword(s):  
Mental Status ◽  
Japanese Encephalitis ◽  
Febrile Seizures ◽  
Acute Onset ◽  
Age Group ◽  
Medical College ◽  
Acute Encephalitis Syndrome ◽  
Acute Encephalitis ◽  
Epidemiological Pattern ◽  
New Onset

Background: Acute Encephalitis Syndrome (AES) is defined as a person of any age, at any time of year with the acute onset of fever 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). Viruses have been mainly attributed to be the cause of AES in India although other etiologies such as bacteria, fungus, parasites, spirochetes, leptospira, toxoplasma, rickettsia, chemical, and toxins have also been reported over the past few years. The causative agent of AES varies with season and geographical location, owing to wide range of causative agents and the rapid neurological impairment due to pathogenesis, clinicians face the challenge of a small window period between diagnosis and treatment. The present study is dedicated to knowing the present epidemiological pattern of AES in Bihar aiming to help in diagnosis and treatment.Methods: This is a prospective study conducted in the department of pediatrics, Patna Medical College and Hospital, Patna from January 1st to December 31st, 2016, in this study all cases which presented with acute onset of fever 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. Demographic, etiological analysis and outcome of cases of Acute Encephalitic Syndrome as well as Japanese encephalitis were done.Results: The total number of patient diagnosed clinically with AES were 186 of them 105 were male and 81 were female. Number of cases were highest in the age group of >5-10 years amounting to 37.7% followed by 26.4% in >2-5 years age group, marked male predominance was seen in the age group 5 -10 years. A minor female predominance was observed in the age group >10 years. In May number of cases were maximum 36 (19.4%) followed by April 32 (17.2%), number of cases of AES were least in the month of December followed by November (8). Maximum number of cases were from the district of Patna and its neighboring district amounting to 58.5% with Nalanda district alone comprises 24.3%. Etiological analysis reveals that 36.5% children admitted with the clinical diagnosis of AES, 36.5% were diagnosed with Acute bacterial meningoencephalitis and 22.04% were diagnosed with Japanese Encephalitis, 7.5% Tuberculous meningitis, 6.4% Cerebral malaria, 5.4% Herpes simplex encephalitis and 3.2% with acute encephalitis syndrome unknown.Conclusions: Acute Encephalitis Syndrome remains an important cause of prolonged hospital bed occupancy with a high rate of mortality. Although in JE positive cases mortality were less, but morbidity in form of various motor deficit and cognitive impairment increases the burden on the family and society. With the introduction of effective JE vaccine and with rigorous surveillance of AES cases and social initiative taken by the Government, we can hope a better scenario. More and more extensive studies are the need of hour to know more about the etiopathogenesis of AES, so that future strategies to bring down the mortality and morbidity due to this disease can be carried out. 

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