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DOI: 10.1055/s-0044-1787102
Outcome and Prognostic Factors of Pediatric Encephalitis in Thailand
Abstract
Encephalitis, a severe central nervous system infection, poses significant morbidity and mortality risks. Etiologically, this condition can arise from infections or immune-mediated mechanisms, with varying causative agents across regions. Despite limited studies on pediatric encephalitis in Thailand, our retrospective cohort study aimed to discern the characteristics, outcomes, and prognostic factors influencing clinical results. We examined patients under 15 years of age admitted to Maharat Nakhon Ratchasima Hospital from January 1, 2007 to December 31, 2022, recording baseline data encompassing clinical manifestations, etiology, investigations, and treatments. The study defined outcomes in terms of morbidity, subsequent epilepsy incidence, and mortality rates evaluated via the modified Rankin Scale. Among 183 enrolled patients (age range 5 days to 15 years, mean age 7.4 years), males comprised 54.1%. Viral encephalitis (35.52%) and immune-mediated encephalitis (22.4%) emerged as the prevailing etiologies, with herpes simplex, dengue, and influenza virus as prominent viral pathogens. Anti-N-methyl-D-aspartame receptor encephalitis (56.1%) led among immune-mediated cases. Initially, 94.53% of patients displayed moderate-to-severe disability, while 45.7% exhibited clinical improvement within 6 months. Subsequent epilepsy ensued in 38.8% of cases, with an overall mortality rate of 19%, notably higher in viral encephalitis instances. Our findings underscore a predilection for viral pathogens in pediatric encephalitis cases, contributing to inferior prognoses. This study accentuates the necessity of understanding etiological patterns and prognostic markers to enhance clinical outcomes in this vulnerable population segment.
Publication History
Received: 28 December 2023
Accepted: 12 April 2024
Article published online:
27 May 2024
© 2024. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)
Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany
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