Aetiological Study of Viruses Causing Acute Encephalitis Syndrome in North West India

Tiwari, Jitendra Kumar; Malhotra, Bharti; Chauhan, Astha; Malhotra, Hemant; Sharma, Pratibha; Deeba, Farah; Trivedi, Khushbu; Swamy, Anjenya M

doi:10.4103/ijmm.ijmm_17_180

Cited by 13 publications

(10 citation statements)

References 26 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Japanese encephalitis with Dengue, Japanese encephalitis with tubercular, Japanese encephalitis with Mumps and Japanese encephalitis with Scrub typhus. This is similar to study by Jain P, et al, where mixed infections were found in 12 patients and study by Tiwari JK, et al, which showed multiple etiology in 9 patients [12,7]. Hence in tropical countries endemic diseases and multiple etiologies can be considered.…”

Section: Discussionsupporting

confidence: 90%

“…In this study we observed that 21% of cases were having microbiologically confirmed viral etiology. This was similar to the study done by Tiwari JK, et al, from Rajasthan who studied 3088 patients of all age group and viral etiology was confirmed in 22.7% cases [7]. Other studies also documented almost similar percentage of viral causes which includes 17.2 % in study by Rathore SK, et [8][9][10][11].…”

Section: Discussionsupporting

confidence: 87%

“…AES is caused by various agents like bacteria, fungi and parasite, the viruses are implicated to be the most important cause [2]. Global incidence varies between According to the study done by Kumar R, et al, viral etiology was found in 57.58% and another study by Tiwari JK, et al, had a viral etiology in of 41.10% (in children) [6,7]. Hence an average of 50% prevalence is considered and a sample size of 100 is calculated with an estimated true proportion rate (R) of 0.50 at a confidence level of 95% assuming desired precision rate of 20% (Relative error).…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Viral Etiology in Acute Encephalitis Syndrome in North Indian Children

Aggarwal¹

2022

JCIM

View full text Add to dashboard Cite

Background and Objective: Acute Encephalitis Syndrome (AES) leads to significant mortality and morbidity in children. This study was undertaken to identify the viral causes of AES and its correlation with clinicodemographic profile. Methods: This cross-sectional study included 100 children aged 1 to 12 years presenting with fever of <14 days duration 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) [1]. Cerebrospinal Fluid (CSF) was collected aseptically by lumbar puncture for biochemical and cytological analysis, and for bacteriological culture. Multiplex PCR for the viruses HSV1, HSV2, Varicella zoster virus, Enterovirus, Mumps and Parecho virus was carried out. Serology for Japanese Encephalitis (JE) was done in blood and CSF by ELISA method. Dengue NS1 antigen and IgM ELISA was carried out in both blood and CSF samples. Serum IgM antibody for scrub typhus was done by ELISA method. Results: Out of 100 children viral cause was detected in 21 patients (Japanese encephalitis -16, Dengue – 4, Varicella zoster virus, Enterovirus and Mumps virus – 1 each). Serum IgM ELISA for scrub typhus was positive in 6 patients. Multiple viral etiology was seen in 2 patients. Mortality was significantly more in females (p=0.021), GCS <8 (p <0.001). Mortality was significantly more with higher CSF neutrophils and higher proteins (p<0.05). Interpretation and Conclusion: This study concludes that viral causes specially JE contributed in AES in North India. Hence viral pathogens including JE needs to be considered as one of major causative agents while treating patients of AES and further emphasis has to be given for JE vaccination in this region.

show abstract

Section: Discussionsupporting

confidence: 90%

Section: Discussionsupporting

confidence: 87%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Viral Etiology in Acute Encephalitis Syndrome in North Indian Children

Aggarwal¹

2022

JCIM

View full text Add to dashboard Cite

show abstract

“…Viral meningitis is usually caused by enteroviruses or herpes simplex virus type 2 (HSV-2) [8], whereas a specific etiology of encephalitis had been documented in only 30.4% of cases [9]. In one of the largest Indian studies including both adults and children by Tiwari et al [10], virus identification (serologically or by molecular testing) was possible in 22.7% of acute encephalitis syndrome (AES). The most common virus identified in AES suspects in their study was HSV (8.4%), followed by Epstein Barr virus (EBV) (5.6%), VZV (3.1%), Cytomegalovirus (CMV) (2.2%), Enterovirus (EV) (1.0%), Mumps virus (MPV) (0.9%), Dengue virus (DV) (0.9%).…”

Section: Discussionmentioning

confidence: 99%

Microbial Etiology of Community Acquired Meningoencephalitis In Adults: A Retrospective Review

Saxena¹,

Kaur²,

RANDHAWA³

2021

Journal of Microbiology and Infectious Diseases

View full text Add to dashboard Cite

Objectives: Meningoencephalitis (ME) is a well-recognized clinical entity with diverse infectious etiologies. Only a few studies in the Indian literature are available on this issue, especially in the adult population. The aim is to study the microbial etiology of ME presenting to a tertiary care center. Methods: A total of 97 cases labeled as ME were initially found on review of hospital records in a retrospective review over 5 years. Of these, only 62 were microbiologically confirmed and these were selected for this study. Results: Bacteria were the cause in 21(34%) cases. Pneumococcus was the predominant bacterial etiology, found in 17 cases (detected by PCR in 15 and by culture in 3 cases). Viruses were seen in 13 (21%) cases; Herpes simplex virus (HSV) was seen in 4 cases and enterovirus and varicella in 2 cases each (all were detected by PCR). We also had Arboviruses: Chikungunya (3 cases) and Dengue (2 cases) (serological diagnosis). TB was found in 15 (24%) cases (diagnosed by positive CSF Xpert Mtb in 11 cases and by AFB culture in 7 cases). Cryptococcus was seen in another 13 (21%) cases (detected by positive CSF CRAG in all cases and culture positivity in 7 cases). Conclusion: Pneumococcus and HSV are the commonest agents causing acute ME syndrome. Mycobacterium tuberculosis and Cryptococcus accounted for all cases of chronic ME. Multiplex PCR (in acute ME) and Xpert Mtb and cryptococcal antigen (in chronic ME) play an important role in the diagnosis of culture-negative ME.

show abstract

“…Viruses have been mainly attributed to be the cause of AES in India though other microbes and toxins have been reported over the past few decades. [1][2][3][4][5][6][7] Noninfective causes of acute encephalitic presentation are increasingly being recognized worldwide. 8 Various infective and noninfective etiologies of AES have been tabulated in Table 1.…”

Section: Causes /Etiologymentioning

confidence: 99%

Acute Encephalitis Syndrome: Approach to a Changing Paradigm

Banerjee¹,

Muhammed²,

Acharya³

2019

Pediatric Infectious Disease

View full text Add to dashboard Cite

Purpose: Acute encephalitis syndrome (AES) poses challenges to physicians owing to acute presentation, often rapid neurologic deterioration, myriad causes including noninfective inflammatory disorders of central nervous system (CNS) and low microbiologic yield. We broadly discuss common and less common causes of AES and their clinical, laboratory including radiologic features as specific diagnosis guides management and improves outcome. Materials and methods: Literature search was performed using keywords "Paediatric acute encephalitis" in MEDLINE database from 2009 to 2019 and all relevant articles (barring case reports) in English language were reviewed. Landmark articles prior to 2009 were also reviewed. Conclusion:Acute encephalitis remains a diagnostic and therapeutic challenge in neurocritical care. The recognition of etiological agent and encephalitis mimics by investigations is important for specific therapeutic measures. Judicious use of neuroimaging, cerebrospinal fluid (CSF) analysis and appropriate lab tests helps in diagnosing specific entities especially noninfective mimics of AES which has important treatment and prognostic implication. Initial stabilization and institution of supportive measures remains key to successful management.

show abstract

Aetiological Study of Viruses Causing Acute Encephalitis Syndrome in North West India

Abstract: AES occurred sporadically in Rajasthan, samples should be tested first for herpes group of viruses followed by EV or/and for arboviruses depending on season or measles, mumps and RVs in children.

Cited by 13 publications

References 26 publications

Viral Etiology in Acute Encephalitis Syndrome in North Indian Children

Viral Etiology in Acute Encephalitis Syndrome in North Indian Children

Microbial Etiology of Community Acquired Meningoencephalitis In Adults: A Retrospective Review

Acute Encephalitis Syndrome: Approach to a Changing Paradigm

Contact Info

Product

Resources

About