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. 2022 Oct 1;41(10):806-812.
doi: 10.1097/INF.0000000000003637. Epub 2022 Jul 14.

Etiology and Risk Factors for Admission to the Pediatric Intensive Care Unit in Children With Encephalitis in a Developing Country

María P Guerrero  1 , Andrés F Romero  2   3 , Miguel Luengas  4   5 , Diana M Dávalos  6   7 , Juan Gonzalo Mesa-Monsalve  8 , Rosalba Vivas-Trochez  9 , German Camacho-Moreno  4   10 , Mónica Trujillo-Valencia  11   12   13 , Juan P Calle Giraldo  6   14 , Luis F Mejía  15 , Juan P Rojas-Hernández  1   15   16 , Nathaly Vinasco  16 , Andrea Ruiz Racines  16 , Alejandro Meléndez  16 , Claudia P Beltrán  17 , Pio López  1   6 , Yamile Chaucanez  18 , Jaime Patiño  19 , Wilfrido Coronell Rodríguez  20 , Doris Salgado  2 , Marly Martínez  2 , Andrea Restrepo  4   10 , Kelly Márquez  4   10 , Diego Galvis  4 , Iván Benavidez  1 , Christian A Rojas  1 , Erika Cantor  6   21 , Eduardo López Medina  1   6   22
Affiliations

Etiology and Risk Factors for Admission to the Pediatric Intensive Care Unit in Children With Encephalitis in a Developing Country

María P Guerrero et al. Pediatr Infect Dis J. .

Abstract

Objective: To describe a cohort of pediatric patients with encephalitis and their risk factors for admission to the pediatric intensive care unit (PICU).

Study design: Children (<18 years old), with encephalitis evaluated by conventional microbiology and syndromic, multiplex test in cerebrospinal fluid (CSF) between July 2017 and July 2020, were recruited from 14 hospitals that comprise the Colombian Network of Encephalitis in Pediatrics. Multivariate analyses were used to evaluate risk factors associated with the need for PICU admission.

Results: Two hundred two children were included, of which 134 (66.3%) were male. The median age was 23 months (IQR 5.7-73.2). The main etiologies were bacteria (n = 55, 27%), unspecified viral encephalitis (n = 44, 22%) and enteroviruses (n = 27, 13%), with variations according to age group. Seventy-eight patients (38.6%) required management in the PICU. In multivariate analysis, factors associated with admission to the PICU were the presence of generalized seizures (OR 2.73; 95% CI: 1.82-4.11), status epilepticus (OR 3.28; 95% CI: 2.32-4.62) and low leukocyte counts in the CSF (OR 2.86; 95% CI: 1.47-5.57). Compared with enterovirus, bacterial etiology (OR 7.50; 95% CI: 1.0-56.72), herpes simplex encephalitis (OR 11.81; 95% CI: 1.44-96.64), autoimmune encephalitis (OR 22.55; 95% CI: 3.68-138.16) and other viral infections (OR 5.83; 95% CI: 1.09-31.20) increased the risk of PICU admission.

Conclusions: Data from this national collaborative network of pediatric patients with encephalitis allow early identification of children at risk of needing advanced care and can guide the risk stratification of admission to the PICU.

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Conflict of interest statement

The authors have no funding or conflicts of interest to disclose.

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