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. 2018 Jun 3:2018:3587014.
doi: 10.1155/2018/3587014. eCollection 2018.

The Etiological Spectrum of Febrile Encephalopathy in Adult Patients: A Cross-Sectional Study from a Developing Country

Elham Peidaee  1 , Fereshte Sheybani  2   3 , HamidReza Naderi  2 , Nasrin Khosravi  4 , Mehdi Jabbari Nooghabi  5
Affiliations

The Etiological Spectrum of Febrile Encephalopathy in Adult Patients: A Cross-Sectional Study from a Developing Country

Elham Peidaee et al. Emerg Med Int. .

Abstract

The profile of febrile encephalopathy varies based on different demographic and geographical characteristics of the study population. This retrospective, cross-sectional study was conducted to evaluate the etiological spectrum of febrile encephalopathy in hospitalized adult patients. A total of 293 patients with the mean age of 49.7 ± 23 were evaluated of whom 77.1% presented with encephalopathy syndrome. The most common diagnosis in patients with clinical syndromes suggestive of central nervous system (CNS) infection was sepsis associated encephalopathy (SAE) (22.9%), followed by bacterial meningitis (14%) and neurotuberculosis (9.9%). The comparison between the elderly and young adults showed that, in the young adults, bacterial meningitis and neurotuberculosis, and in the elderly SAE, are among the most common causes of clinical syndromes suggestive of CNS infection including febrile encephalopathy in our region. Moreover, we illustrated an upward trend for the proportion of diagnosing CNS infections among those who underwent diagnostic LP, from 40.4% in 2011 to 70% in 2015, that could be indicative of an increasing threshold for performing LP at least in our center in recent years. Whether these changes have been associated with increasing the rate of diagnostic errors or not needs to be evaluated in future studies.

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Figures

Figure 1
Figure 1
Final diagnosis of clinical syndromes suggestive of CNS infection. Metabolic E: Metabolic Encephalopathy; Toxic E: Toxic Encephalopathy; SAE: Sepsis Associated Encephalopathy; VZV: Varicella Zoster Virus.
Figure 2
Figure 2
The proportion of patients with CNS infections to all cases with febrile encephalopathy.
Figure 3
Figure 3
The comparison of frequency distribution of the final diagnosis in patients with febrile encephalopathy syndrome between the elderly (≥65 years) and young adults (<65 years). HSV: Herpes Simplex Virus; VZV: Varicella Zoster Virus; SAE: Sepsis Associated Encephalopathy; E.: Encephalopathy.
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References

    1. Yeolekar M. E., Trivedi T. H. Febrile encephalopathy: Challenges in management. Journal of the Association of Physicians of India. 2006;54:845–847. - PubMed
    1. Huff S., Hockberger R., Grayzel J. Evaluation of Abnormal Behavior in the Emergency Department. https://www.uptodate.com/contents/evaluation-of-abnormal-behavior-in-the....
    1. Sheybani F., Naderi H., Sajjadi S. The optimal management of acute febrile encephalopathy in the aged patient: a systematic review. Interdisciplinary Perspectives on Infectious Diseases. 2016;2016 doi: 10.1155/2016/5273651.5273651 - DOI - PMC - PubMed
    1. Tunkel A. R. Approach to the patient with central nervous system infection. In: Bennett J., Dolin R., Blaser M., editors. Principles and Practice of Infectious Diseases. Elsevier; 2015. pp. 1091–1096.
    1. Roos K. L., Tyler K. L. Meningitis, encephalitis, brain abscess, and empyema. In: Kasper D., editor. Harrison's Principles of Internal Medicine. 19th. New York: Mcgraw-hill; 2015.

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