Introduction: Acute encephalitis syndrome (AES) is a major health problem in Eastern Uttar
Pradesh, India since 1978 with heavy morbidity and mortality. The main cause of such epidemic AES
has been an arthropod borne viral infection caused by Japanese encephalitis (JE) virus. However since
2006,there is a change in pattern, with JE positivity progressively decreases in AES cases.
Aims & objectives: To study the pattern of infections in AES in adults.
Methods: Total 200AES casesof age ≥ 18 years, admitted in Medicine department of B.R.D. Medical
college, Gorakhpur were studied. It was a prospective study with one month follow up. A detailed
demography, clinical features, investigations, complications and outcome was noted.
Results & conclusion: The maximum patients came during September and October. The common
presenting symptoms were fever and altered sensorium followed by headache, vomiting, seizures,
abdominal pain and loose stools. The most common CNS examination finding was plantar extensor
(65%), followed by signs of meningeal irritation (57.5%), brisk DTR (16.5%) and papilledema
(11.5%). Extrapyramidal signs (5%), cerebellar signs (4.5%) and hemiparesis (3%) were uncommon
presentations. Aspiration pneumonitis was the commonest secondary complication during
hospitalization (17%). Full recovery was seen in 72.5% of AES patients. The commonest sequelae
was cognitive impairment (5.5%), followed by psychosis (4.5%) and extrapyramidal symptoms (2%).
The commonest cause of AES was acute viral (Non JE) encephalitis (57.5%), followed by Japanese
encephalitis (29%), acute bacterial meningitis (8.5%) and cerebral malaria (5%). The case fatality rate
of AES was 13%.
Key words: Acute encephalitis syndrome (AES), Japanese encephalitis (JE), Clinical symptoms,
Outcome, Case fatality rate, CSF findings.
|
