Long‐term outcomes of infective encephalitis in children: a systematic review and meta‐analysis

Khandaker, Gulam; Jung, Jenny; Britton, Philip N; King, Catherine; Yin, Jiehui Kevin; Jones, Cheryl

doi:10.1111/dmcn.13197

Cited by 71 publications

(78 citation statements)

References 43 publications

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“…These findings are consistent with those from other countries, where 16% of children hospitalised with confirmed HPeV infection had significant neurological sequelae 24 . These data also appear to be consistent with outcomes from other causes of encephalitis 40 …”

Section: Managing Parechovirus Infectionsupporting

confidence: 90%

Parechovirus: an important emerging infection in young infants

Britton

Jones

Macartney

et al. 2018

Medical Journal of Australia

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Epidemics of human parechovirus (HPeV) causing disease in young children have occurred every 2 years in Australia since 2013. HPeV genotype 3 caused the epidemic from late 2017 to early 2018. Most HPeV infections cause no or mild symptoms including gastroenteritis or influenza-like illness. Characteristically, young infants present with fever, irritability and on occasions a diffuse rash ("red, hot and angry" babies). Severe disease can manifest as meningoencephalitis, seizures or sepsis-like presentations (including septic shock), or less common presentations including signs of surgical abdomen. Testing for HPeV by specific molecular tests is indicated in children younger than 6 months of age with characteristic presentations without another confirmed diagnosis including febrile illnesses with other suggestive features (eg, rash, seizures), sepsis syndromes (including shock), and suspected meningoencephalitis (which may be detected by magnetic resonance imaging only). There are no effective antiviral therapies. Treatment is primarily supportive, including management of complications. Some infants with severe HPeV infection may have adverse neurodevelopment. Follow-up by a paediatrician is recommended.

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Section: Managing Parechovirus Infectionsupporting

confidence: 90%

Parechovirus: an important emerging infection in young infants

Britton

Jones

Macartney

et al. 2018

Medical Journal of Australia

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“…Meningitis and encephalitis are important causes of mortality and morbidity in children [ 1 , 2 ]. These central nervous system (CNS) infections frequently result in neuro-developmental sequelae [ 3 , 4 ]. The range of pathogens associated with CNS infections is broad with considerable geographic variability [ 5 ].…”

Section: Introductionmentioning

confidence: 99%

The aetiologies of central nervous system infections in hospitalised Cambodian children

et al. 2017

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BackgroundCentral nervous system (CNS) infections are an important cause of childhood morbidity and mortality. The aetiologies of these potentially vaccine-preventable infections have not been well established in Cambodia.MethodsWe did a one year prospective study of children hospitalised with suspected CNS infection at Angkor Hospital for Children, Siem Reap. Cerebrospinal fluid specimens (CSF) samples underwent culture, multiplex PCR and serological analysis to identify a range of bacterial and viral pathogens. Viral metagenomics was performed on a subset of pathogen negative specimens.ResultsBetween 1st October 2014 and 30th September 2015, 284 analysable patients were enrolled. The median patient age was 2.6 years; 62.0% were aged <5 years. CSF white blood cell count was ≥10 cells/μL in 116/272 (42.6%) cases. CNS infection was microbiologically confirmed in 55 children (19.3%). Enteroviruses (21/55), Japanese encephalitis virus (17/55), and Streptococcus pneumoniae (7/55) accounted for 45 (81.8%) of all pathogens identified. Of the pathogens detected, 74.5% (41/55) were viruses and 23.6% (13/55) were bacteria. The majority of patients were treated with ceftriaxone empirically. The case fatality rate was 2.5%.ConclusionsEnteroviruses, JEV and S. pneumoniae are the most frequently detected causes of CNS infection in hospitalised Cambodian children.

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“…Encephalitis is an inflammation of the brain parenchyma which can lead to serious neurological sequelae and even death among younger children 1,2) .…”

Section: Introductionmentioning

confidence: 99%

Recovery without Neurological Sequelae in Fulminant Cerebral Edema in Pediatric Encephalitis with Human Herpesvirus Type 6

Park¹,

Kim²,

Kwon³

2018

journalofthekoreanchildneurologysociety

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Viral encephalitis can lead to serious neurological sequelae and death among younger children. It is also known that the mortality rate in encephalitis with cerebral edema or transtentorial brain herniation is higher. A 4-year-old boy visited our emergency department exhibiting mental change. The patient had a high fever for four and a whole-body rash for three days prior to his visit. He had displayed irritable symptoms and been vomiting for six hours before his visit, accompanied by seizure. After 13 hours of admission, the patient's right pupil became fixed and fully dilated, and the left pupil also became fixed and fully dilated within 30 minutes. Brain computed tomography (CT) was performed immediately, and severe brain swelling with transtentorial brain herniation was found. The mannitol dose was increased and dexamethasone was also added. Hyperventilation was performed through intubation to reach PaCO 2 levels of 25 to 30mmHg. Fifteen hours later, pupillary reflex was observed and the cerebral edema and transtentorial brain herniation was found to be improving in follow-up brain CT. He was transferred to a general ward after 11 days and discharged on the thirteenth hospital day without any neurological sequelae. Human herpesvirus type 6 (HHV-6) was detected in the serological polymerase chain reaction (PCR) examination.

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Long‐term outcomes of infective encephalitis in children: a systematic review and meta‐analysis

Cited by 71 publications

References 43 publications

Parechovirus: an important emerging infection in young infants

Parechovirus: an important emerging infection in young infants

The aetiologies of central nervous system infections in hospitalised Cambodian children

Recovery without Neurological Sequelae in Fulminant Cerebral Edema in Pediatric Encephalitis with Human Herpesvirus Type 6

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