Incidence and associated factors of adverse outcome in children admitted with acute encephalitis syndrome at a tertiary care hospital

Abstract Background: Since there is currently no specific antiviral medication for acute encephalitis syndrome (AES), including Japanese encephalitis (JE), cases are treated symptomatically. For a better result, case management must be prompt and efficient. Pediatric JE patients hospitalized with AES have clinical characteristics and outcomes that are still poorly understood. Objective: The objective of this study is to study the incidence and associated factors of adverse outcome, i.e., death, in children admitted with AES. Materials and Methods: Hospital-based prospective study was carried out among children aged 1 month to 12 years of age, admitted with provisional diagnosis of AES. Thorough history, clinical examinations, baseline tests, some particular investigations, lumbar puncture for cerebrospinal fluid analysis, and additional biochemical and radiographic study was carried out for all cases. Results: Majority (32.2%) were 5–8 years. Females were slightly more than males. Cases from rural areas were more than two-thirds. All presented with fever, 80% with seizures; 60.0% with vomiting. 14% showed signs of papilledema. The most common cause was viral in 24.4% followed by bacterial in 11.1%. Incidence of adverse outcome, i.e., death, was 28.9% and significant associated factors were low or high white blood cell count, low Glasgow coma scale <8, those with shock and inotrope use, those requiring mechanical ventilation, and higher SGPT values. Conclusion: AES is an important cause of morbidity and mortality, especially during the Monsoon and postmonsoon period. Viral encephalitis is an important cause of AES. No JE cases were reported in the present study.