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Epidemiology and Etiology of Severe Childhood Encephalitis in The Netherlands

de Blauw, Dirkje ; Bruning, Andrea H.L ; Busch, C.B.E ; Kolodziej, Lisa M ; Jansen, N.J.G ; van Woensel, J.B.M ; Pajkrt, Dasja

The Pediatric infectious disease journal, 2020-04, Vol.39 (4), p.267-272 [Periódico revisado por pares]

United States: Copyright Wolters Kluwer Health, Inc. All rights reserved

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Título:
Epidemiology and Etiology of Severe Childhood Encephalitis in The Netherlands
Autor: de Blauw, Dirkje ; Bruning, Andrea H.L ; Busch, C.B.E ; Kolodziej, Lisa M ; Jansen, N.J.G ; van Woensel, J.B.M ; Pajkrt, Dasja
Assuntos: Child ; Child, Preschool ; Encephalitis - epidemiology ; Encephalitis - etiology ; Encephalitis - mortality ; Encephalitis, Viral - diagnosis ; Encephalitis, Viral - epidemiology ; Encephalitis, Viral - mortality ; Female ; Hospitalization - statistics & numerical data ; Humans ; Infant ; Infectious Encephalitis - diagnosis ; Infectious Encephalitis - epidemiology ; Infectious Encephalitis - mortality ; Intensive Care Units, Pediatric - statistics & numerical data ; Male ; Netherlands - epidemiology ; Original Studies ; Retrospective Studies ; Severity of Illness Index
É parte de: The Pediatric infectious disease journal, 2020-04, Vol.39 (4), p.267-272
Notas: ObjectType-Article-1
SourceType-Scholarly Journals-1
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Descrição: BACKGROUND:Limited data are available on childhood encephalitis. Our study aimed to increase insight on clinical presentation, etiology, and clinical outcome of children with severe encephalitis in the Netherlands. METHODS:We identified patients through the Dutch Pediatric Intensive Care Evaluation database and included children diagnosed with encephalitis <18 years of age admitted to 1 of the 8 pediatric intensive care units (PICU) in the Netherlands between January 2003 and December 2013. We analyzed demographic characteristics, clinical symptoms, neurologic imaging, etiology, treatment and mortality. RESULTS:We included 121 children with a median age of 4.6 years (IQR 1.3–9.8). The most frequently described clinical features were headache (82.1%), decreased consciousness (79.8%) and seizures (69.8%). In 44.6% of the children, no causative agent was identified. Viral- and immune-mediated encephalitis were diagnosed in 33.1% and 10.7% of the patients. A herpes simplex virus infection (13.2%) was mainly seen in children <5 years of age, median age, 1.73 years (IQR 0.77–5.01), while immune-mediated encephalitis mostly affected older children, median age of 10.4 years (IQR, 3.72–14.18). An age of ≥ 5 years at initial presentation was associated with a lower mortality (OR 0.2 [CI 0.08–0.78]). The detection of a bacterial (OR 9.4 [CI 2.18–40.46]) or viral (OR 3.7 [CI 1.16–11.73]) pathogen was associated with a higher mortality. CONCLUSIONS:In almost half of the Dutch children presenting with severe encephalitis, a causative pathogen could not be identified, underlining the need for enhancement of microbiologic diagnostics. The detection of a bacterial or viral pathogen was associated with a higher mortality.
Editor: United States: Copyright Wolters Kluwer Health, Inc. All rights reserved
Idioma: Inglês

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Epidemiology and Etiology of Severe Childhood Encephalitis in The Netherlands

de Blauw, Dirkje ; Bruning, Andrea H.L ; Busch, C.B.E ; Kolodziej, Lisa M ; Jansen, N.J.G ; van Woensel, J.B.M ; Pajkrt, Dasja

United States: Copyright Wolters Kluwer Health, Inc. All rights reserved

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