Clinical profile and outcomes in acute viral encephalitis

Objective@#This study aimed to determine the clinical profile and outcome of pediatric patients with acute viral encephalitis syndrome admitted at a single tertiary government hospital. @*Methods@#All pediatric patients admitted at the Philippine General Hospital from January 2011 to December 2014 and discharged with a final diagnosis of acute viral encephalitis were included. After demographic data, clinical manifestations, and laboratory findings were collected, the outcome was determined using the Modified Rankin Scale for children. The data were summarized using descriptive statistics. The median test was used to compare the outcomes while the chi-square test was used to analyze the comparison between study groups. @*Results@#Sixty-four patients diagnosed with acute viral encephalitis syndrome were included in the study. The highest number of cases was reported in ages 1- 4 years (32.81%) and among the male population (68.75%). The most common symptoms were seizure (46.87%), abnormal behavior (21.88%), and altered sensorium (20.31%). Forty-four patients had CSF viral studies done, and among them, the 11 (25%) were positive for Japanese encephalitis. The modified Rankin scale showed that 41 (64.08 %) subjects showed good outcomes, while 23 (35.23%) exhibited poor outcomes. There was no significant difference in the modified Rankin scale for Japanese encephalitis compared to the other etiologic agents of acute viral encephalitis (p value= 0.717). @*Conclusion@#In patients with acute viral encephalitis, the most common symptoms were seizures, abnormal behavior, and altered sensorium. Majority of the subjects did not show any significant symptoms and disability. No difference was seen in the clinical outcome of patients infected with Japanese encephalitis compared to other etiologic agents, but these results need to be verified by larger studies.<

The Roles and Perspectives of Toll-Like Receptors and CD4+ Helper T Cell Subsets in Acute Viral Encephalitis

Acute viral encephalitis caused by neurotrophic viruses, such as mosquito-borne flaviviruses, is an emerging and re-emerging disease that represents an immense global health problem. Considerable progression has been made in understanding the pathogenesis of acute viral encephalitis, but the immune-pathological processes occurring during the progression of encephalitis and the roles played by various molecules and cellular components of the innate and adaptive systems still remain undefined. Recent findings reveal the significant contribution of Toll-like receptors (TLRs) and regulatory CD4+ T cells in the outcomes of infectious diseases caused by neurotrophic viruses. In this review, we discuss the ample evidence focused on the roles of TLRs and CD4+ helper T cell subsets on the progression of acute viral encephalitis. Finally, we draw attention to the importance of these molecules and cellular components in defining the pathogenesis of acute viral encephalitis, thereby providing new therapeutic avenues for this disease.

Management of acute viral encephalitis in Brazil

The appropriate management of acute viral encephalitis is a challenge. Clinical picture includes general symptoms and a wide range of neurological signs. Etiological diagnosis cannot be performed only by clinical means and depends on neuroimaging studies and cerebrospinal fluid molecular analyses. It is recommended since some of these viruses are treatable and that the prognoses of these infections depend on the prompt administration of antiviral and/or immunomodulatory drugs. The management of acute viral encephalitis in Brazil has some peculiarities. First, the etiological distribution of the viral encephalitis may differ from what is found in other countries. Some viruses, such as dengue virus, are more common in Brazil than in developed countries while others, like West Nile virus, are not found here. Second, there are some regions in Brazil where neuroimaging and laboratorial methods are not available, and a clinical-based decision is the only therapeutic approach. As most of the guidelines in the literature are based on complimentary methods, it is relevant to establish an alternative approach compatible with the Brazilian health system reality. The goal of this study was to review the recent advances in the field of the acute viral encephalitis, to discuss the diagnosis and the treatment of the main etiologies of acute viral encephalitis found in Brazil, and to propose a viable guideline for the evaluation of the suspected acute viral encephalitis cases in the emergence room in Brazil.

Study on prethrombotic state in children with acute viral encephalitis / 实用儿科临床杂志

Objective To investigate whether there is prethrombotic state in acute viral encephalitis.Methods Von willebrand factors (VWF),granule membrane protein-140(GMP-140) and D-dimer were measured in 60 children,30 cases of them had mild acute viral encephalitis, and other 30 cases of them had severe acute viral encephalitis.Results The figures mentioned above had marked difference in children with mild acute viral encephalitis during acute and recovery stage compared with controls.Conclusions Testing the expressive rate of GMP-140 on platelet surface,plasma VWF and D-dimer can find the prethrombotic state immediately. GMP-140,VWF and D-dimer in estimating the severe extent of disease and the prognosis play a major role. J Appl Clin Pediatr,2004,19(6):501-503