1014. Long Term Outcomes of Acute Aseptic Encephalitis In Adults - a Single Center Study
Session: Poster Abstract Session: Adult CNS Infection
Friday, October 6, 2017
Room: Poster Hall CD
Posters
  • Long Term Outcomes of Acute Aseptic Encephalitis In Adults - a Single Center Study.pdf (375.4 kB)
  • Background: Encephalitis is a heterogeneous syndrome associated with significant mortality and neurophysiological sequelae. The etiology is identified in only 20-50% of cases, and long-term outcomes of survivors are underinvestigated, especially in patients with unknown etiology. The aim of this study was to describe long-term outcomes of patients with aseptic encephalitis of various etiologies.

    Methods: The study population consisted of a retrospectively identified cohort of consecutive adult patients diagnosed with viral and etiologically undiagnosed encephalitis during a 24-month period (2014-2015) at the University Hospital for Infectious Diseases Zagreb, Croatia. Clinical, laboratory data and short-term outcomes were collected from medical records, and long-term outcomes were assessed by telephone interviews and quantified through modified Rankin scores (mRS).

    Results: A total of 90 patients were identified (57.7% female; 51.5±17.4 years). Viral etiology was identified in 20 (22.2%) patients: herpes simplex virus (HSV-1, 8.9%), varicella zoster virus (VZV, 6.7%), Tick-borne encephalitis (TBE, 4.4%) and enteroviruses (2.2%). Postinfectious meningoencephalitis was suspected in 14 (15.6%) patients, and 56 (62.2%) had unknown etiology. Elevated CSF WBC was present in 77 patients (mean of 169.3±279.4/mm3) and all but 6 had elevated CSF proteins (1.23±0.88 g/L). Convulsions occurred more frequently in HSV-1 (37.5%) and in unknown etiology group (15.7%). GOS<3 was noted in 50% of HSV, 33% of VZV, 25% of TBE and 24% of unknown group patients during hospitalization. Mechanical ventilation was necessary in 17.1% of patients with unknown and 23.5% with viral etiology for the mean duration of 1.8±6.7 and 3.2±6.3 days, respectively. The mean length of stay was 23.2±18.5 days. In-hospital mortality was 7.8%. Among 64 survivors who were available for follow-up interviews (mean follow up of 28.6±6.8 months), 73.1% with unknown and 90.9% with viral etiology had favorable outcomes (mRS 0-1); 4 (6.25%) had moderate (mRS 3) and 3 (4.6%) had severe neuropsychological deficits (mRS 4-5).

    Conclusion: Although the etiology of aseptic encephalitis is often unknown, long-term outcomes are favorable in the majority of patients.

    Marija Kusulja, MD1, Marija Santini, MD, PhD2 and Neven Papic, MD, PhD1, (1)University Hospital for Infectious Diseases Zagreb, Zagreb, Croatia, (2)School of Medicine, University of Zagreb, Zagreb, Croatia

    Disclosures:

    M. Kusulja, None

    M. Santini, None

    N. Papic, None

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