Etiology and Risk Factors for Admission to the Pediatric Intensive Care Unit in Children With Encephalitis in a Developing Country. Issue 10 (14th July 2022)

• Record Type: Journal Article
• Authors: Guerrero, María P.; Romero, Andrés F.; Luengas, Miguel; Dávalos, Diana M.; Mesa-Monsalve, Juan Gonzalo; Vivas-Trochez, Rosalba; Camacho-Moreno, German; Trujillo-Valencia, Mónica; Giraldo, Juan P. Calle; Mejía, Luis F.; Rojas-Hernández, Juan P.; Vinasco, Nathaly; Racines, Andrea Ruiz; Meléndez, Alejandro; Beltrán, Claudia P.; López, Pio; Chaucanez, Yamile; Patiño, Jaime; Rodríguez, Wilfrido Coronell; Salgado, Doris; Martínez, Marly; Restrepo, Andrea; Márquez, Kelly; Galvis, Diego; Benavidez, Iván; Rojas, Christian A.; Cantor, Erika; López Medina, Eduardo
• Is Part Of: Pediatric infectious disease journal. Volume 41:Issue 10(2022)
• Page Start: 806
• Page End: 812
• Publication Date: 2022-07-14
• Subjects: Encephalitis -- risk factors -- PICU -- etiology -- children; Communicable diseases in children -- Periodicals; Infection in children -- Periodicals; 618.929
• DOI: 10.1097/INF.0000000000003637
• Languages: English
• ISSNs: 0891-3668

Abstract

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.