Spectrum and outcome of acute infectious encephalitis/encephalopathy in an intensive care unit from India

Kalita, Jayantee; Mani, Vinita Elizabeth; Bhoi, Sanjeev Kumar; Misra, Usha Kant

doi:10.1093/qjmed/hcw132

Cited by 12 publications

(14 citation statements)

References 31 publications

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“…In our data, 71% (5/7) of patients with anti-NMDAR encephalitis developed extrapyramidal symptoms. Seizures are common in AE and may occur at any stage of the disease, and studies have revealed that status epilepticus can predict a poor outcome for encephalitis (44, 45). Several studies on the death factors of encephalitis in the ICU have shown that status epilepticus, central hypoventilation, and complications (such as multiple organ dysfunction or severe pulmonary infection) are predictors of poor prognosis of encephalitis (44, 46, 47).…”

Section: Discussionmentioning

confidence: 99%

Analysis of Clinical Characteristics and Poor Prognostic Predictors in Patients With an Initial Diagnosis of Autoimmune Encephalitis

Qiu

Zhang

et al. 2019

Front. Immunol.

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Purpose: We aimed to retrospectively analyze the clinical features, laboratory and imaging results, and predictors of poor prognosis for patients with an initial diagnosis of autoimmune encephalitis (AE) at the Affiliated Hospital of Zunyi Medical University. Methods: Fifty patients with an initial diagnosis of AE who were admitted to our hospital from May 2014 to May 2018 were enrolled retrospectively. Clinical characteristics and experimental test data, including the neutrophil-to-lymphocyte ratio (NLR), were collected from medical records within 24 h of admission. Independent prognostic factors were determined by multivariate logistic regression analysis. A good or poor prognosis for patients was defined based on the modified Rankin Scale (mRS). The correlation between the immunotherapy latency and prognostic mRS score was determined using the Spearman rank correlation test. Results: Univariate analysis indicated that increased NLR ( P = 0.001), decreased lymphocyte counts ( P = 0.001), low serum albumin ( P = 0.017), consciousness disorders ( P = 0.001), epileptic seizures ( P = 0.007), extrapyramidal symptoms ( P = 0.042), abnormal electroencephalogram (EEG) findings ( P = 0.001), abnormal brain magnetic resonance imaging (MRI) findings ( P = 0.003), and pulmonary infection complications ( P = 0.000) were associated with the poor prognosis of AE. Multivariate logistic regression analysis showed that NLR (odds ratio [OR] 2.169, 95% confidence interval [CI] 1.029–4.570; P < 0.05) was an independent risk factor for predicting the poor prognosis of AE. NLR > 4.45 was suggested as the cut-off threshold for predicting the adverse outcomes of AE. In addition, we revealed that there was a positive correlation between immunotherapy latency and mRS score (r s = 0.535, P < 0.05). Conclusions: NLR may have predictive value for the poor outcomes of AE. Early initiation of immunotherapy is associated with a good prognosis.

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Section: Discussionmentioning

confidence: 99%

Analysis of Clinical Characteristics and Poor Prognostic Predictors in Patients With an Initial Diagnosis of Autoimmune Encephalitis

Qiu

Zhang

et al. 2019

Front. Immunol.

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“…We here present a case of scrub typhus (ST) manifesting with a large intracerebral hemorrhage, of which, to the best of our knowledge, only nine cases have been reported in the English language worldwide. [ 1 2 3 4 5 6 7 8 ] Most of these were secondary to deranged coagulation profile, disseminated intravascular coagulation (DIC) and/or hemophagocytic lymphohistiocytosis (HLH), which were absent in this case.…”

Section: Introductionmentioning

confidence: 88%

Scrub typhus manifesting with intracerebral hemorrhage: Case report and review of literature

Kotwal

Vaish

Gupta

et al. 2020

J Family Med Prim Care

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Scrub typhus (ST), hitherto absent from many parts of India, is now recently being recognized as a significant cause of morbidity and mortality throughout the country. Its diverse clinical presentations, low of the index of suspicion by the treating physician, and lack of diagnostic testing in many parts of the country result in delayed treatment, leading to a host of complications. We here report such a complication, where ST manifested with a large intracerebral hemorrhage, of which, to the best of our knowledge, only nine cases have been reported in the English language worldwide. Family physicians, who are the often first point of contact for treatment of febrile illness, as ST typically manifests, need to be aware of this entity to prevent such catastrophic consequences.

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“…In another study conducted on children with encephalitis, 44.8% patients required mechanical ventilation ( 20 ). In 2017, a study was conducted in India which concluded that 42% patients with encephalitis need invasive ventilation ( 21 ). In comparison to the above studies, our study also increased an increased number (58.7%) of encephalitis patients on invasive ventilation and only 9.3% patients on non-invasive ventilation.…”

Section: Discussionmentioning

confidence: 99%

“…Furthermore, in recent studies, the reported incidence of seizures at the time of presentation was 42%–50% ( 25 – 27 ). In addition, according to the study published in 2017, the documented incidence of seizures in patients with encephalitis was almost 50% ( 21 ).…”

Section: Discussionmentioning

confidence: 99%

Incidence of Encephalitis in the Intensive Care Unit, a Tertiary Care Hospital, Pakistan: A 5-Year Retrospective Study

Andleeb

Bari

Gill

et al. 2020

Turk J Anaesthesiol Reanim

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Spectrum and outcome of acute infectious encephalitis/encephalopathy in an intensive care unit from India

Abstract: Twenty-six percent patients with AIES died in ICU, and 86% had good recovery at 3 months. Admission SOFA scores and untreatable etiology predicted mortality.

Cited by 12 publications

References 31 publications

Analysis of Clinical Characteristics and Poor Prognostic Predictors in Patients With an Initial Diagnosis of Autoimmune Encephalitis

Analysis of Clinical Characteristics and Poor Prognostic Predictors in Patients With an Initial Diagnosis of Autoimmune Encephalitis

Scrub typhus manifesting with intracerebral hemorrhage: Case report and review of literature

Incidence of Encephalitis in the Intensive Care Unit, a Tertiary Care Hospital, Pakistan: A 5-Year Retrospective Study

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