Cross-sectional observational study to assess the clinic-demographic profile in children with Acute Encephalitis Syndrome

Abstract

Aim: to evaluate the clinical profile and outcome of AES in hospitalized children. Material and Methods: This Cross-sectional, observational study was done the Department of Paediatrics,Vardhman Institute of Medical Science, Pawapuri, Nalanda, Bihar, India, for 1 year.. Children between age 1 month to 15 years with the acute onset of fever and a change in mental status such as confusion, disorientation, coma or inability to talk and/or new onset of seizures (excluding simple febrile seizure) were included in study. All cases were investigated Cerebrospinal Fluid (CSF) analysis, dengue serology, radiological investigation as per clinical presentation. Results: among 100 AES cases most of them were above 10 years of age (34%). Majority of them were males 65(65%), and 35(35%) were females. Most of the cases were reported during monsoon period 55(55%), followed by post-monsoon 34(34%) and pre-monsoon 11(11%). Out of 100 cases, all had fever; 72 (72%) had altered sensorium, 57 (57%) had convulsion; 27 (27%) had headache; 43 (43%) had vomiting. On fundus examination 29 (29%) showed papilledema. Out of 100 cases 55(55%) had viral etiology, 23(23%) had dengue, 6(6%) had malaria, 4 (4%) bacterial etiology, 6 (6%) had tuberculosis, 5 (5%) had other causes. Those patients who had shock and need inotropes showed significant mortality (p-value: 0.015. Out of 23 patients put on mechanical ventilation 10 died which was statistically significant with p -value 0.001. Those patients had deranged Liver Function Test (LFT) profile also had significant higher mortality (p- value: 0.027). Out of 100 children of AES admitted in Pediatric Intensive Care Unit (PICU) 69(69%) were discharge, 18(18%) were succumbed, 13(13%) were got Discharge against Medical Advice. Conclusion: Majority of cases were in the age-group of above 10 years, with male predominance. The peak in occurrence of cases was during post-monsoon period.