Etiology of acute childhood encephalitis at The Hospital for Sick Children, Toronto, 1994-1995

Clin Infect Dis. 1998 Feb;26(2):398-409. doi: 10.1086/516301.

Abstract

Of 145 patients admitted to our hospital because of encephalitis-like illness, 50 patients hospitalized for > or =72 hours underwent standardized microbiological investigations. A confirmed or probable etiologic agent was identified in 20 cases (40%), including Mycoplasma pneumoniae (9 cases). M. pneumoniae and enterovirus (2), herpes simplex virus (4), Epstein-Barr virus (1), human herpes-virus 6 (HHV-6) (1), HHV-6 and influenza virus type A (1), influenza virus type A (1), and Powassan virus (1). In 13 cases (26%), a possible pathogen was identified, including M. pneumoniae in nine cases. Presenting features included fever (80% of patients), seizures (78%), focal neurological findings (78%), and decreased consciousness (47%). The frequency of findings at the time of admission vs. later in hospitalization was as follows: pleocytosis, 59% vs. 63%; electroencephalogram abnormalities, 87% vs. 96%; and neuroimaging abnormalities, 37% vs. 69%, respectively. The outcomes at the time of discharge were as follows: normal results of physical examination, 32% (16) of the patients; death, 2% (1); motor difficulties, 26% (13); global neurological deficits, 16% (severe, 6; mild, 2); mental status changes, 14% (7); visual defects, 8% (4); and hearing impairment, 2% (1).

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Acute Disease
  • Animals
  • Canada
  • Cell Line
  • Child
  • Dogs
  • Electroencephalography
  • Encephalitis / cerebrospinal fluid
  • Encephalitis / etiology*
  • Encephalitis / physiopathology
  • Encephalitis, Viral / cerebrospinal fluid
  • Encephalitis, Viral / physiopathology
  • Encephalitis, Viral / virology
  • Female
  • Hospitals, Pediatric*
  • Hospitals, University*
  • Humans
  • Outcome Assessment, Health Care
  • Prospective Studies
  • Tumor Cells, Cultured