Clinical characteristics and outcomes of patients with Herpes Simplex Encephalitis in Vietnam: a retrospective study.

Autor: Ngan TTD; Department of Infectious Diseases, Hanoi Medical University, 1 Ton That Tung Street, Dong Da district, Hanoi, Vietnam. dr.dieungan@gmail.com.; National Hospital for Tropical Diseases, 78 Giai Phong Street, Dong Da District, Hanoi, Vietnam. dr.dieungan@gmail.com.; Hanoi Medical University Hospital, 1 Ton That Tung Street, Dong Da District, Hanoi, Vietnam. dr.dieungan@gmail.com., Tuyet NT; Thai Nguyen University of Medicine and Pharmacy, 284 Luong Ngoc Quyen Street, Thai Nguyen City, Thai Nguyen Province, Vietnam., Hung DT; Department of Infectious Diseases, Hanoi Medical University, 1 Ton That Tung Street, Dong Da district, Hanoi, Vietnam., Cap NT; National Hospital for Tropical Diseases, 78 Giai Phong Street, Dong Da District, Hanoi, Vietnam., Nguyen DM; Grinnell College, 1115 8th Avenue, Grinnell, IA, 50112, USA., Dat VQ; Department of Infectious Diseases, Hanoi Medical University, 1 Ton That Tung Street, Dong Da district, Hanoi, Vietnam.; Hanoi Medical University Hospital, 1 Ton That Tung Street, Dong Da District, Hanoi, Vietnam.
Jazyk: angličtina
Zdroj: BMC infectious diseases [BMC Infect Dis] 2024 Jun 03; Vol. 24 (1), pp. 556. Date of Electronic Publication: 2024 Jun 03.
DOI: 10.1186/s12879-024-09453-3
Abstrakt: Background: Herpes simplex encephalitis (HSE) is an important central nervous infection with severe neurological sequelae. The aim of this study was to describe clinical characteristic and outcomes of patients with HSE in Vietnam.
Methods: This was a retrospective study of 66 patients with herpes simplex encephalitis who admitted to the National Hospital for Tropical Diseases, Hanoi, Vietnam from 2018 to 2021. The detection of herpes simplex virus (HSV) in cerebrospinal fluid was made by the real-time PCR assay. We reported the clinical manifestation on admission and evaluated clinical outcomes at the hospital discharge by modified Rankin Scale (mRS). Multivariate logistic regression analysis was used to analyze the independent risk factors of severe outcomes.
Results: Of the 66 patients with laboratory confirmed HSE, the median age was 53 years (IQR 38-60) and 44 patients (69.7%) were male. The most common manifestations included fever (100%), followed by the consciousness disorder (95.5%). Other neurological manifestation were seizures (36.4%), memory disorders (31.8%), language disorders (19.7%) and behavioral disorders (13.6%). Conventional magnetic resonance imaging (MRI) showed 93.8% patients with temporal lobe lesions, followed by abnormalities in insula (50%), frontal lobe (34.4%) and 48.4% of patients had bilateral lesions. At discharge, 19 patients (28.8%) completely recovered, 15 patients (22.7%) had mild sequelae, 28 patients (42.4%) had moderate to severe sequelae. Severe neurological sequelae were memory disorders (55.8%), movement disorders (53.5%), language disorders (30.2%). Multivariate logistic regression analysis showed that Glasgow score decrement at admission, seizures, and time duration from onset of symptoms to the start of Acyclovir treatment > 4 days were independent factors associated with severe outcomes in HSE patients.
Conclusion: Glasgow score decrement, seizures and delay treatment with Acyclovir were associated with the poor outcome of patients with HSE.
(© 2024. The Author(s).)
Databáze: MEDLINE
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