Comparative study of clinical features, severity of manifestations and outcome in patients with acute encephalitis syndrome with shock and without shock

Background: Acute Encephalitis Syndrome (AES) poses a significant public health challenge globally due to its high morbidity and mortality rates. The incidence of AES varies, with viruses being the predominant causative agents. Shock is a severe complication in AES patients, necessitating prompt recognition and management to improve outcomes. Methods: A prospective study was conducted from August 2018 to November 2020 at two medical centers in Cuttack, focusing on AES patients aged 6 months to 14 years. Clinical features, laboratory parameters, and outcomes were compared between AES patients with (N=30) and without shock (N=70). Results: AES patients with shock presented with more severe clinical features, including lower Glasgow Coma Scale scores, unstable vital signs, and significant abnormalities in laboratory parameters such as hemoglobin levels, blood glucose, liver and renal function, and coagulation studies. Shock patients required more aggressive therapeutic interventions, including vasopressors and mechanical ventilation. Mortality was significantly higher in the shock group (50%) compared to the non-shock group (7%), with refractory shock associated with a 100% mortality rate. However, complete recovery rates were lower in the shock group (40% vs. 81.4%). Conclusion: Shock in AES patients is associated with a more severe clinical course and poorer outcomes, highlighting the importance of early recognition and aggressive management strategies.