Long-term outcome of acute encephalitis of unknown aetiology in adults.
Clin Microbiol Infect. 2010 Jun 1;
Authors: Schmidt A, Bühler R, Mühlemann K, Hess CW, Täuber MG
Abstract Encephalitis is caused by a variety of conditions, including infections of the brain by a wide range of pathogens. A substantial number of cases of encephalitis defy all attempts at identifying a specific cause. Little is known about the long-term prognosis in patients with encephalitis of unknown aetiology, which complicates their management during the acute illness. In order to learn more about the prognosis of patients with encephalitis of unknown aetiology, patients in whom no aetiology could be identified were examined in a large, single-center encephalitis cohort. In addition to analysing the clinical data of the acute illness, surviving patients were assessed by phone interview a minimum of two years after the acute illness by applying a standardized test battery. Of the patients with encephalitis who qualified for inclusion (n=203), 39 patients (19.2%) had encephalitis of unknown aetiology. The case fatality in these patients was 12.8%. Among the survivors, 53% suffered from various neurologic sequelae, most often attention and sensory deficits. Among the features at presentation that were associated with adverse outcome were older age, increased C-reactive protein, coma, and high percentage of polymorphonuclear cells in CSF. In conclusion, outcome in an unselected cohort of patients with encephalitis of unknown aetiology was marked by substantial case fatality and by long-term neurologic deficits in about half of the surviving patients. Certain features on admission predicted an unfavourable outcome.
PMID: 20518796 [PubMed - as supplied by publisher]