Epidemiology and clinical outcomes of viral central nervous system infections
| Autor: | Fatma Ben Abid, Said Al Dhahry, Adeel A. Butt, Abdullatif Al Khal, Mohammed Abukhattab, Hussam Al Soub, Hafedh Ghazouani, Samar Hashim, Ahmed Gohar, Eman Al Masalamani, Faraj Howadi, Muna Al Maslamani, Obada Khalil |
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| Rok vydání: | 2018 |
| Předmět: |
Adult
Male Microbiology (medical) medicine.medical_specialty Adolescent viruses Population Acyclovir Myelitis medicine.disease_cause Young Adult 03 medical and health sciences 0302 clinical medicine Internal medicine medicine Humans 030212 general & internal medicine education Qatar Retrospective Studies education.field_of_study business.industry Incidence Incidence (epidemiology) Varicella zoster virus General Medicine Middle Aged medicine.disease Infectious Diseases Central Nervous System Viral Diseases Etiology Ceftriaxone Female business Meningitis 030217 neurology & neurosurgery Encephalitis medicine.drug |
| Zdroj: | International Journal of Infectious Diseases. 73:85-90 |
| ISSN: | 1201-9712 |
| Popis: | Background Central nervous system (CNS) viral infections are an important cause of morbidity and mortality. No data are available regarding their epidemiology in Qatar. Design We retrospectively evaluated all cerebrospinal fluid findings from January 2011–March 2015 at Hamad Medical Corporation. Those with abnormal CSF finding were included in our study. We excluded those with missing medical records, no clinical evidence of viral CNS infection, or proven bacterial, fungal or tuberculosis CNS infection. CNS clinical findings were classified as meningitis, encephalitis or myelitis. Results Among 7690 patients with available CSF results, 550 cases met the inclusion criteria (meningitis 74.7%; encephalitis 25%; myelitis 0.4%). Two-thirds (65%) were male and 50% were between 16–60 years old. Viral etiology was confirmed in 38% (enterovirus, 44.3%; Epstein-Barr virus, 31%; varicella zoster virus, 12.4%). The estimated incidence was 6.4 per 100,000 population. Two persons died and the rest were discharged to home. Among those with confirmed viral etiology, 83.8% received ceftriaxone (mean duration 7.3 ± 5.2 days), 38% received vancomycin (mean duration 2.7 ± 5.4 days) and 38% received at least one other antibiotic. Intravenous acyclovir was continued for more than 48 h in patients with confirmed negative viral etiology (mean duration 5 ± 5.6 days). Conclusion Viral etiology is not uncommon among those evaluated for CNS infection in Qatar. Clinical outcomes are excellent in this group of patients. Antibiotics and acyclovir are overly used even when a viral etiology is confirmed. There is a need for clinician education regarding etiology and treatment of viral CNS infections. |
| Databáze: | OpenAIRE |
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