La Crosse encephalitis in children
| Autor: | Theodore F. Tsai, Emily de los Reyes, Ann Thompson, Manuel J. Caceres, Jose E. Irazuzta, James E. McJunkin, Raheel R. Khan, Kai D. Fu, Gretchen D. Lovett, Linda L. Minnich |
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| Rok vydání: | 2001 |
| Předmět: |
Male
Pediatrics medicine.medical_specialty Pathology La Crosse virus Adolescent Fever Vomiting Statistics Nonparametric La Crosse encephalitis Encephalitis California Risk Factors medicine Humans Meningitis Aseptic Child Intracranial pressure Retrospective Studies Analysis of Variance business.industry Aseptic meningitis Brain Infant Electroencephalography General Medicine medicine.disease El Niño Child Preschool Female medicine.symptom Nervous System Diseases Hyponatremia business Tomography X-Ray Computed Encephalitis |
| Zdroj: | The New England journal of medicine. 344(11) |
| ISSN: | 0028-4793 |
| Popis: | La Crosse encephalitis is a mosquito-borne disease that can be mistaken for herpes simplex encephalitis. It has been reported in 28 states but may be underrecognized.We investigated the manifestations and clinical course of La Crosse encephalitis in 127 patients hospitalized from 1987 through 1996. The diagnosis was established by serologic testing for IgM and IgG antibodies to La Crosse virus. Data were collected by chart review.Most of the patients were school-aged children (mean [+/-SD] age, 7.8+/-3.5 years; range, 0.5 to 15.0). Symptoms included headache, fever, and vomiting (each in 70 percent or more of the patients), seizures (in 46 percent), and disorientation (in 42 percent). Thirteen percent had aseptic meningitis. Hyponatremia developed in 21 percent, and there were signs of increased intracranial pressure in 13 percent. Six patients, including three with cerebral herniation, underwent intracranial-pressure monitoring. The 13 patients (11 percent) whose condition deteriorated in the hospital had decreases in serum sodium levels (P=0.007), and increases in body temperature (P=0.003) at the time of deterioration. At admission, these patients more often had a history of vomiting (P=0.047) and a score of 12 or lower on the Glasgow Coma Scale (P=0.02) than the others; a trend toward a greater prevalence of seizures at admission was also evident in this group (P=0.07). All the patients survived, but 15 of them (12 percent) had neurologic deficits at discharge. Follow-up assessments, performed in 28 children, suggested an increase in cognitive and behavioral deficits 10 to 18 months after the episode of encephalitis.La Crosse virus infection should be considered in children who present with aseptic meningitis or encephalitis. Hyponatremia and increasing body temperature may be related to clinical deterioration. |
| Databáze: | OpenAIRE |
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