Etiology of acute childhood encephalitis at The Hospital for Sick Children, Toronto, 1994-1995.
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).
Kolski
H
H
Department of Pediatrics, The Hospital for Sick Children and the University of Toronto, Ontario, Canada.
Ford-Jones
E L
EL
Richardson
S
S
Petric
M
M
Nelson
S
S
Jamieson
F
F
Blaser
S
S
Gold
R
R
Otsubo
H
H
Heurter
H
H
MacGregor
D
D
D000208:Acute Disease; D000818:Animals; D002170:Canada; D002460:Cell Line; D002648:Child; D004285:Dogs; D004569:Electroencephalography; D004660:Encephalitis / Q000134:cerebrospinal fluid / Q000209:etiology* / Q000503:physiopathology; D018792:Encephalitis, Viral / Q000134:cerebrospinal fluid / Q000503:physiopathology / Q000821:virology; D005260:Female; D006776:Hospitals, Pediatric; D006785:Hospitals, University; D006801:Humans; D017063:Outcome Assessment, Health Care; D011446:Prospective Studies; D014407:Tumor Cells, Cultured