A 9-month retrospective evaluation of the aetiology and management of patients presenting with encephalitis/meningoencephalitis at a South London hospital

Tehmina Bharucha*, Lina Nashef, Nick Moran, Sue Watkins, David Brown, Mark Zuckerman

*Corresponding author for this work

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Abstract

Encephalitis causes high morbidity and mortality. An incidence of 4.3 cases of encephalitis/100 000 population has been reported in the UK. We performed a retrospective evaluation of the diagnosis and management of adults admitted to hospital with a clinical diagnosis of encephalitis/meningoencephalitis. Clinical, laboratory and radiological data were collated from electronic records. Thirty-six patients, median age 55 years and 24 (67%) male were included. The aetiology was confirmed over nine months in 25 (69%) of whom 16 were infections (six viral, seven bacterial, two parasitic and one viral and parasitic co-infection); 7 autoimmune; 1 metabolic and 1 neoplastic. Of 24 patients with fever, 15 (63%) had an infection. The median time to computed topography, magnetic resonance imaging and electroencephalography (EEG) was 1, 8 and 3 days respectively. Neuroimaging was abnormal in 25 (69%) and 17 (89%) had abnormal EEGs. Only 19 (53%) received aciclovir treatment. Six (17%) made good recoveries, 16 (44%) had moderate disability, 8 (22%) severe disability and 6 (17%) died. Outcomes were worse for those with an infectious cause. In summary, a diagnosis was made in 69.4% of patients admitted with encephalitis/meningoencephalitis. Autoimmune causes are important to consider at an early stage due to a successful response to treatment. Only 53% of patients received aciclovir on admission. Neuroimaging and EEG studies were delayed. The results of this work resulted in further developing the clinical algorithm for managing these patients.

Original languageEnglish
Article numbere23
JournalEpidemiology and Infection
Volume148
Early online date5 Feb 2020
DOIs
Publication statusE-pub ahead of print - 5 Feb 2020

Bibliographical note

Funding Information: No Funding Information

Open Access: This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.

Publisher Copyright:© The Author(s), 2020. Published by Cambridge University Press.

Citation: Bharucha T, Nashef L, Moran, N, Watkins S, Brown D, Zuckerman M (2020). A 9-month retrospective evaluation of the aetiology and management of patients presenting with encephalitis/meningoencephalitis at a South London
hospital. Epidemiology and Infection 148, e23, 1–4.

DOI: https://doi.org/10.1017/S0950268820000047

Keywords

  • Encephalitis
  • infectious disease
  • infectious disease epidemiology

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