Journal Article

Etiology of Acute Childhood Encephalitis at The Hospital for Sick Children, Toronto, 1994–1995

H. Kolski, E. L. Ford-Jones, S. Richardson, M. Petric, S. Nelson, F. Jamieson, S. Blaser, R. Gold, H. Otsubo, H. Heurter and D. MacGregor

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 26, issue 2, pages 398-409
Published in print February 1998 | ISSN: 1058-4838
Published online February 1998 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/516301
Etiology of Acute Childhood Encephalitis at The Hospital for Sick Children, Toronto, 1994–1995

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Of 145 patients admitted to our hospital because of encephalitis-like illness, 50 patients hospitalized for ⩾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 herpesvirus 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).

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Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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