A 9-month retrospective evaluation of the aetiology and management of patients presenting with encephalitis/meningoencephalitis at a South London hospital
| Autor: | Nick Moran, Lina Nashef, Tehmina Bharucha, David W. Brown, Mark Zuckerman, Sue Watkins |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
0301 basic medicine
Adult Male Pediatrics medicine.medical_specialty Epidemiology infectious disease 030106 microbiology Population Neuroimaging Communicable Diseases Autoimmune Diseases 03 medical and health sciences 0302 clinical medicine Meningoencephalitis Neoplasms London medicine Humans 030212 general & internal medicine Aciclovir education Retrospective Studies education.field_of_study Original Paper medicine.diagnostic_test business.industry Diagnostic Tests Routine Incidence infectious disease epidemiology Disease Management Magnetic resonance imaging Middle Aged medicine.disease Survival Analysis Hospitals Infectious Diseases Infectious disease (medical specialty) Radiological weapon Etiology Encephalitis Female business medicine.drug |
| Zdroj: | Epidemiology and Infection |
| ISSN: | 1469-4409 0950-2688 |
| Popis: | Encephalitis causes high morbidity and mortality. An incidence of 4.3 cases of encephalitis/100 000 population has been reported in the UK. We performed a retrospective evaluation of the diagnosis and management of adults admitted to hospital with a clinical diagnosis of encephalitis/meningoencephalitis. Clinical, laboratory and radiological data were collated from electronic records. Thirty-six patients, median age 55 years and 24 (67%) male were included. The aetiology was confirmed over nine months in 25 (69%) of whom 16 were infections (six viral, seven bacterial, two parasitic and one viral and parasitic co-infection); 7 autoimmune; 1 metabolic and 1 neoplastic. Of 24 patients with fever, 15 (63%) had an infection. The median time to computed topography, magnetic resonance imaging and electroencephalography (EEG) was 1, 8 and 3 days respectively. Neuroimaging was abnormal in 25 (69%) and 17 (89%) had abnormal EEGs. Only 19 (53%) received aciclovir treatment. Six (17%) made good recoveries, 16 (44%) had moderate disability, 8 (22%) severe disability and 6 (17%) died. Outcomes were worse for those with an infectious cause. In summary, a diagnosis was made in 69.4% of patients admitted with encephalitis/meningoencephalitis. Autoimmune causes are important to consider at an early stage due to a successful response to treatment. Only 53% of patients received aciclovir on admission. Neuroimaging and EEG studies were delayed. The results of this work resulted in further developing the clinical algorithm for managing these patients. |
| Databáze: | OpenAIRE |
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