title: [Etiology, clinical presentation and outcome of severe viral acute childhood encephalitis (ECOVE study)].
abstract: BACKGROUND
  Viral encephalitis are rare and potentially serious conditions with different etiologist, and not always identifiable. Our aim is to describe the etiological, clinical presentation and neurological outcome of viral encephalitis admitted in Paediatrics Intensive Care Units (PICUs) in Spain.
  
  
  METHODS
  Observational prospective multicenter study. Children with viral encephalitis admitted to 14 PICUs, for a period of 3 years (2010-2013) were included. Polymerase chain reaction for the etiological diagnosis and neurotropic virus serology in blood and cerebrospinal fluid were used. Personal history, clinical presentation, evolution and neurological status at discharge were recorded.
  
  
  RESULTS
  80 patients were included with a mean age of 5 years, 70% male. The most relevant clinical symptoms were decreased consciousness (86%), fever (82.4%), seizures (67%), vomiting (42%), headache (27%), agitation (25%) and dis-orientation (23%). The etiologic diagnosis was established in 35%, being more frequent herpes simplex virus and enterovirus. The outcome was discharge without sequelae in 55 patients (69%), mild to moderate sequelae in 19 (23.5%) and severe in 6 (7.5%). Two patients died.
  
  
  CONCLUSIONS
  In the Spanish PICU etiological diagnosis was established only in a third of cases of children with suspected acute viral encephalitis. Despite the clinical severity we observed a low mortality and morbidity rate. At discharge from the PICU, most children had no neurological sequelae or were mild.
authors.affiliation: Hospital Universitario Puerta del Mar, 11009 Cadiz, Espana.
authors.forename: José C
authors.initials: JC
authors.lastname: Flores-Gonzalez
authors.forename: Iolanda
authors.initials: I
authors.lastname: Jordan-Garcia
authors.forename: Eulàlia
authors.initials: E
authors.lastname: Turon-Vinas
authors.forename: Cristina
authors.initials: C
authors.lastname: Montero-Valladares
authors.forename: Cinta
authors.initials: C
authors.lastname: Tellez-Gonzalez
authors.forename: Francisco
authors.initials: F
authors.lastname: Fernandez-Carrion
authors.forename: Juan P
authors.initials: JP
authors.lastname: Garcia-Iniguez
authors.forename: Eider
authors.initials: E
authors.lastname: Onate-Vergara
authors.forename: Antonio
authors.initials: A
authors.lastname: Rodriguez-Nunez
mesh_terms: D000208:Acute Disease; D000212:Acyclovir / Q000627:therapeutic use; D000293:Adolescent; D000998:Antiviral Agents / Q000627:therapeutic use; D001925:Brain Damage, Chronic / Q000209:etiology; D002648:Child; D002675:Child, Preschool; D017291:Clarithromycin / Q000627:therapeutic use; D003244:Consciousness Disorders / Q000209:etiology; D018792:Encephalitis, Viral / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy / Q000821:virology; D005260:Female; D005334:Fever / Q000209:etiology; D006261:Headache / Q000209:etiology; D006801:Humans; D007223:Infant; D008297:Male; D011446:Prospective Studies; D012621:Seasons; D012640:Seizures / Q000209:etiology; D012698:Serologic Tests; D013030:Spain / Q000453:epidemiology; D016896:Treatment Outcome; D014839:Vomiting / Q000209:etiology
chemical_list: D000998:Antiviral Agents; D017291:Clarithromycin; D000212:Acyclovir