An Epidemiological Study On Clinical Profile And Short Term Outcome In Children Of Acute Encephalitis Syndrome In A\Tertiary Care Center Of West Bengal With Special Reference To The Various Prognostic Markers
Journal Title: IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) - Year 2017, Vol 17, Issue 2
Abstract
Introduction : Incidence of acute encephalitis is high in children and associated with high mortality and sequalae. It is critical to evaluate the child immediately to reduce mortality and sequalae and to identify the cause of Acute Encephalitis Syndrome (AES). Aim of the study was to document the clinical profile, short term outcome, find out possible etiologies of AES and effect of different prognostic markers in outcome of AES at the end of hospital stay. Methods : This prospective observational study was conducted in the pediatric department of NRS medical College & Hospital, Kolkata for period of one year (1st April 2015 to 31st March 2016) on a sample size of 140 patients presenting with fever and altered sensorium (between ages one month to 12 years) and etiology of AES was determined on the basis of history, clinical examination, relevant investigations. Outcome of patients was graded with functional outcome score (Glasgow outcome scale) Results : The most common cause of AES was acute viral encephalitis (JE and non JE). Second most common cause was pyogenic meningitis followed by tubercular meningitis, ADEM and cerebral malaria. 19.01% cases died and 23.23% patients were discharged with sequalae. 57.74% patients were discharged with complete recovery. Maximum mortality and maximum sequalae was found in viral encephalitis (age group 1-5 years, male). Most common type of sequalae was extrapyramidal abnormality. 11 cases of JE IgM positive cases were found out of which 5 died and 6were discharged with sequalae. Out of 14 significant variables, only 10 were found to be significant (p<0.05) lke seizure, shock, GCS <8 and ↑ICT. Conclusion : AES is a disorder of multiple and varying etiology with significant mortality and morbidity. Early diagnosis, appropriate investigation, prompt management and prevention by vaccination go a long way in reducing mortality and sequalae in AES.
Authors and Affiliations
Rajarshi Basu1, MD Kalamuddin
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