Clinical and etiological profile of acute febrile encephalopathy in Eastern Nepal

Abstract

Pyogenic meningitis and viral encephalitis including JE are the most common causes of acute presentation with fever and encephalopathy. Preventive strategies must be directed keeping these causes in mind.

Clinical Profile of Children with Acute Febrile Encephalopathy in a Tertiary Health Care Center of Nepal

“…Four (8.3% The fever was present for less than 72 hours in 47.8% of children in the current study which is more than that noted by Singh et al 3 from Nepal and less than that noted by Anga et al of Papua New Guinea 2 . In the same study made by Singh et al in a ter ary center of Eastern Nepal, the mean dura on of altered sensorium and of GCS was 27.9 ± 19.1 hours and 9.6 ± 3.2 respec vely with 96.3% of children having the altered sensorium for less than 72 hours which is similar to the observa on made in the current study 3 . Similarly the median GCS of 12 in our study was similar to that made by Anga et al where the median was 13 2 .…”

“…In our study seizure was the most common symptom which was present in 59.3% which was followed by vomi ng and headache. Analysis of the symptoms were done by various authors were Rayamajhi et al and Singh et al no ced seizures to be present in 58% and 50% of children respec vely 3,9 blood and CSF cultures, peripheral smear and serology for malarial parasite, and serology for Japanese encephali s (JE. The various clinical signs and symptoms as described in Table 2 is consistent with that noted by diff erent na onal and interna onal authors 2,3,9 58 had JE.…”

“…This diff use and nonspecifi c brain insult manifested by a combina on of coma, seizures and decerebra on, is an important cause of morbidity and mortality in young hospitalized children 3 making signifi cant demands of intensive and high dependency care resources 4 .…”

“…The profi le of acute febrile encephalopathy varies not only in diff erent geographical regions of world but also in diff erent areas and seasons in the same country 3 . Although central nervous system infec on is the most common cause of fever with altered sensorium in children throughout the world, 4 it can result from a wide variety of primary e ologies, posing a diagnos c challenge to medical staff .…”

“…Bacterial meningi s, asep c meningi s, encephali s, cerebral malaria, CNS tuberculosis and enteric encephalopathy are some of the common causes. 3 The survivors are o en le with disabling neurological problems if not diagnosed in me and aggressively managed 1,5 . Outcome of such illness may range from complete recovery through varying degrees of neurological disability to death from either acute ilness or complica ons.…”