The Etiological Diagnosis and Outcome in Patients of Acute Viral Encephalitis: A Prospective Observational Study at Tertiary Care Centre of North India

Deepak Bhagch, V. Atam, S. Thadani, K. Sawlani, I. Atam, A. Thadani
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Abstract

Background: Encephalitis, despite being an uncommon entity, is of public health importance worldwide because of its high morbidity and mortality. Around 70% of the disease burden is in Uttar Pradesh itself. Purpose of study: To study the etiological prevalence and outcome of different viruses as causative agent of acute viral encephalitis in patients reporting to a tertiary health care center in North India. Methods: All the patients presenting with febrile encephalopathy attending the medicine outdoor patient department or emergency of medicine department were enrolled in the study, of these a total of 92 patients fulfilling the inclusion criteria were included in the study. An informed consent from the patients/their attendants was obtained. Results: Minimum age of patients was found to be 14 years while maximum age was 61 years. Around 65.22% were males and majority of the patients were from Barabanki (22.83%). Magnetic Resonance Imaging findings were found to be positive in 85.87%. Most common etiology was Japanese encephalitis (38.04%) with human immunodeficiency Virus encephalitis (3.26%) being least common. After a follow up at 1 month, neurological sequelae were found to be highest in Japanese encephalitis while 100% mortality in human immunodeficiency virus encephalitis and recovery was highest in Dengue encephalitis (85.00%). Difference in outcome of different types of encephalitis was found to be statistically significant. Recovery was highest in age group up to 20 years (57.69%). Difference in outcome and age of patients was found to be statistically significant. Conclusion: Early Reporting, appropriate workup and stabilization of the suspected acute viral encephalitis patients are important so as to reduce the morbidity and mortality.
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急性病毒性脑炎患者的病因诊断和预后:印度北部三级保健中心的前瞻性观察研究
背景:脑炎尽管是一种罕见的疾病,但由于其高发病率和死亡率,在世界范围内具有重要的公共卫生意义。大约70%的疾病负担在北方邦本身。研究目的:研究在印度北部三级卫生保健中心报告的急性病毒性脑炎患者中不同病毒作为病原体的病因学流行率和结果。方法:将所有在内科室外病人科或内科急诊科就诊的发热性脑病患者纳入研究,其中符合纳入标准的患者共92例。获得患者/其护理人员的知情同意。结果:患者最小年龄14岁,最大年龄61岁。男性占65.22%,Barabanki地区占22.83%。85.87%的患者mri表现为阳性。最常见的病因是日本脑炎(38.04%),最少的是人类免疫缺陷病毒脑炎(3.26%)。随访1个月后,日本脑炎的神经系统后遗症最高,人类免疫缺陷病毒脑炎的死亡率为100%,登革脑炎的康复率最高(85.00%)。不同类型脑炎的转归差异有统计学意义。20岁以下年龄组康复率最高(57.69%)。结果和患者年龄的差异有统计学意义。结论:对疑似急性病毒性脑炎患者的早期报告、适当的随访和稳定治疗对降低发病率和死亡率至关重要。
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