Clinical presentation of severe viral encephalitis with known causative agents in children: a retrospective study on 16 patients hospitalized in a pediatric intensive care unit (2008-2011).
A retrospective analysis was conducted in a French pediatric hospital in Lyon. Subjects were 16 patients diagnosed with acute viral encephalitis with identified causative agents who were admitted to the pediatric intensive care unit from 2008 to 2011. The median length of stay was 6 days. The outcome was favorable for 77% of the patients. Analysis of biological and clinical findings based on causative agents did not reveal clinical patterns or neurological findings specific to the causal viruses. Nevertheless, uncommon clinical pictures and severe neurological complications were highlighted, in particular for children with influenza-related encephalitis and herpes simplex encephalitis. This case series exemplifies the difficulties, even pitfalls, in establishing a diagnosis of encephalitis, especially in neonates. It points out significant differences in the clinical presentation of encephalitis in children compared with clinical pictures described in previously published large-scale studies on encephalitis mainly conducted in adults.
Pediatric Emergency and Intensive Care Unit, Hospices Civils de Lyon, Lyon, France marc.adenot@voila.fr.
Marc
M
Adenot
Laboratoire de Virologie Est, Centre de Biologie et Pathologie Est, Hospices Civils de Lyon, Lyon, France Virology and Human Pathology, EMR 4610, Faculté de Médecine RTH Laënnec, Université Claude Bernard Lyon 1, Lyon, France.
Emilie
E
Frobert
Pediatric Neurology, Hôpital Femme-Mère-Enfant, Hospices Civils de Lyon, Lyon, France.
Gaëlle
G
Blanchard
Département d'Imagerie Pédiatrique et Foetale, Hôpital Femme-Mère-Enfant, Lyon, France.
Benoit
B
Morel
Pôle Information Médicale Evaluation Recherche, Hospices Civils de Lyon, Lyon, France.
Laurence
L
Perrot
Pediatric Emergency and Intensive Care Unit, Hospices Civils de Lyon, Lyon, France University Claude Bernard Lyon 1, France.
Daniel
D
Floret
Pediatric Emergency and Intensive Care Unit, Hospices Civils de Lyon, Lyon, France University Claude Bernard Lyon 1, France.
Etienne
E
Javouhey
D000293:Adolescent; D001921:Brain / Q000473:pathology / Q000503:physiopathology; D002648:Child; D002675:Child, Preschool; D004569:Electroencephalography; D018792:Encephalitis, Viral / Q000209:etiology* / Q000473:pathology / Q000503:physiopathology* / Q000628:therapy; D005500:Follow-Up Studies; D005602:France; D006760:Hospitalization; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D015278:Intensive Care Units, Pediatric; D008279:Magnetic Resonance Imaging; D012189:Retrospective Studies; D016896:Treatment Outcome
encephalitis; herpes; influenza