Changing profile of encephalitis: Results of a 4-year study in France

Mailles, Alexandra; Biron, Charlotte; Fillâtre, Pierre; Broucker, T. de; Buzelé, Rodolphe; Gagneux‐Brunon, Amandine; Gueït, I.; Henry, Carole; Patrat-Delon, Solène; Makinson, Alain; Piet, Emilie; Wille, H.; Vareil, Marc-Olivier; Épaulard, Olivier; Martinot, M.; Tattevin, Pierre; Stahl, Jean-Paul

doi:10.1016/j.idnow.2021.11.007

Cited by 28 publications

(21 citation statements)

References 9 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Table 2 provides details about the treatments used in the ICU. Two-thirds of the patients were treated with 10 mg/kg/8 h of intravenous acyclovir and one-third with 15 mg/kg/8 h for a median duration of 14 (9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19) days. Eight (15%) patients received an additional antiviral drug (foscavir, n = 6, ganciclovir, n = 2) and 3 (5%) were treated with intravenous immunoglobulins.…”

Section: Icu Management and Outcomesmentioning

confidence: 99%

“…9 Service de Réanimation Médicale, Hôpital Brabois, Nancy, France. 10 Service de Médecine Intensive et Réanimation, Hôpital Cochin, APHP, Paris, France. 11 Service de médecine intensive et réanimation, Groupement Hospitalier Nord, Hospices Civils de Lyon, Université de Lyon, INSERM 955, Créteil, France.…”

Section: Supplementary Informationunclassified

“…Varicella-zoster virus (VZV) is one of the eight herpes viruses known to cause human infections and is the second cause of acute encephalitis in France after herpes simplex virus (HSV) 1 and 2 [2,3,9]. Its incidence has grown over the last decade [10]. The most common neurologic symptoms of VZV infection are meningoencephalitis, cerebellitis, stroke, myelopathy and retinitis.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Neurologic outcome of VZV encephalitis one year after ICU admission: a multicenter cohort study

Mirouse

Sonneville

Razazi

et al. 2022

Ann. Intensive Care

View full text Add to dashboard Cite

Background Varicella-zoster virus (VZV) is one of the main viruses responsible of acute encephalitis. However, data on the prognosis and neurologic outcome of critically ill patients with VZV encephalitis are limited. We aimed to describe the clinical features of VZV encephalitis in the ICU and to identify factors associated with a favorable neurologic outcome. We performed a multicenter cohort study of patients with VZV encephalitis admitted in 18 ICUs in France between 2000 and 2017. Factors associated with a favorable neurologic outcome, defined by a modified Rankin Score (mRS) of 0–2 1 year after ICU admission, were identified by multivariable regression analysis. Results Fifty-five patients (29 (53%) men, median age 53 (interquartile range 36–66)) were included, of whom 43 (78%) were immunocompromised. ICU admission occurred 1 (0–3) day after the onset of neurological symptoms. Median Glasgow Coma Score at ICU admission was 12 (7–14). Cerebrospinal fluid examination displayed a median leukocyte count of 68 (13–129)/mm3, and a median protein level of 1.37 (0.77–3.67) g/L. CT scan and MRI revealed brain lesions in 30% and 66% of the cases, respectively. Invasive mechanical ventilation was implemented in 46 (84%) patients for a median duration of 13 (3–30) days. Fourteen (25%) patients died in the ICU. One year after ICU admission, 20 (36%) patients had a favorable neurologic outcome (mRS 0–2), 12 (22%) had significant disability (mRS 3–5), and 18 (33%) were deceased (lost to follow-up n = 5, 9%). On multivariable analysis, age (OR 0.92 per year, (0.88–0.97), p = 0.01), and invasive mechanical ventilation (OR 0.09 CI 95% (0.01–0.84), p = 0.03) reduced the likelihood of favorable neurologic outcome. Conclusion One in every three critically ill patients with VZV encephalitis had a favorable neurologic outcome 1 year after ICU admission. Older age and invasive mechanical ventilation were associated with a higher risk of disability and death.

show abstract

Section: Icu Management and Outcomesmentioning

confidence: 99%

Section: Supplementary Informationunclassified

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Neurologic outcome of VZV encephalitis one year after ICU admission: a multicenter cohort study

Mirouse

Sonneville

Razazi

et al. 2022

Ann. Intensive Care

View full text Add to dashboard Cite

show abstract

“…The French multicenter ENCEIF cohort on 349 patients with encephalitis found that no initial clinical/imaging/biology pattern at admission was predictive of encephalitis cause [9]. Another analysis of 494 cases of encephalitis from the same cohort revealed that a causative agent was identified in 65.7% of cases, with viruses representing 81.8% of causative agents, especially Herpesviridae (63.6%) [10 ▪ ]. HSV, VZV, and enterovirus represented more than 50% of identified viruses.…”

Section: Epidemiologymentioning

confidence: 99%

Critical care management of meningitis and encephalitis: an update

Thy

Gaudemer

Vellieux

et al. 2022

Current Opinion in Critical Care

View full text Add to dashboard Cite

Purpose of reviewMeningitis and encephalitis represent severe neurological syndromes associated with encephalopathy, seizures, focal deficits, and neurological sequelae in survivors. We update on the critical care management of adult patients with severe meningitis and encephalitis.Recent findingsLarge multicenter studies conducted in the adult population improved current knowledge on the epidemiology and outcomes of patients with severe meningitis and encephalitis. An early multimodal diagnostic workup (including CSF analysis, brain MRI, EEG, and serum studies) is mandatory for diagnosis and prognostication in those patients.New diagnostic methods, including multiplex PCR and next-generation sequencing techniques, allow for a faster differential diagnosis of infectious causes that may require specific antimicrobial therapy. Autoimmune causes of encephalitis, which may require urgent immunotherapy, are also increasingly recognized in the ICU setting. Although observational data suggest that early combined immunotherapy is associated with better neurological outcomes in patients with autoimmune encephalitis, randomized clinical trials have yet to be performed.SummaryOur review highlights the importance of an early multimodal approach for diagnosing severe meningitis and encephalitis. Randomized clinical trials are needed to identify pharmacological interventions that may improve patients’ outcomes.

show abstract

“…Furthermore, there is no mandatory notification of TBE in many countries. Moreover, a recent 4-year prospective cohort study performed in France from 2016 to 2019 (N = 494 cases of encephalitis) indicates that TBEV makes up 8% of encephalitis cases with an identified cause and, compared to a cohort from 2007 (N = 222), a significant increase in TBEV occurred (i.e., the number of causes of TBEV amongst all causes of encephalitis in adult patients was 3/106 and 26/257 in 2007 and 2016–2019, respectively; Fisher’s exact test, p -value = 0.013) [ 34 ].…”

Section: Introductionmentioning

confidence: 99%

First Expert Elicitation of Knowledge on Possible Drivers of Observed Increasing Human Cases of Tick-Borne Encephalitis in Europe

Saegerman

Humblet

Leandri

et al. 2023

Viruses

View full text Add to dashboard Cite

Tick-borne encephalitis (TBE) is a viral disease endemic in Eurasia. The virus is mainly transmitted to humans via ticks and occasionally via the consumption of unpasteurized milk products. The European Centre for Disease Prevention and Control reported an increase in TBE incidence over the past years in Europe as well as the emergence of the disease in new areas. To better understand this phenomenon, we investigated the drivers of TBE emergence and increase in incidence in humans through an expert knowledge elicitation. We listed 59 possible drivers grouped in eight domains and elicited forty European experts to: (i) allocate a score per driver, (ii) weight this score within each domain, and (iii) weight the different domains and attribute an uncertainty level per domain. An overall weighted score per driver was calculated, and drivers with comparable scores were grouped into three terminal nodes using a regression tree analysis. The drivers with the highest scores were: (i) changes in human behavior/activities; (ii) changes in eating habits or consumer demand; (iii) changes in the landscape; (iv) influence of humidity on the survival and transmission of the pathogen; (v) difficulty to control reservoir(s) and/or vector(s); (vi) influence of temperature on virus survival and transmission; (vii) number of wildlife compartments/groups acting as reservoirs or amplifying hosts; (viii) increase of autochthonous wild mammals; and (ix) number of tick species vectors and their distribution. Our results support researchers in prioritizing studies targeting the most relevant drivers of emergence and increasing TBE incidence.

show abstract

Changing profile of encephalitis: Results of a 4-year study in France

Cited by 28 publications

References 9 publications

Neurologic outcome of VZV encephalitis one year after ICU admission: a multicenter cohort study

Neurologic outcome of VZV encephalitis one year after ICU admission: a multicenter cohort study

Critical care management of meningitis and encephalitis: an update

First Expert Elicitation of Knowledge on Possible Drivers of Observed Increasing Human Cases of Tick-Borne Encephalitis in Europe

Contact Info

Product

Resources

About