Table 3. Clinical diagnosis, initial AES classification and final AES classification for 149 children and 231 adults with suspected infections of the central nervous system.
Clinical diagnostic groupa | Etiologyb | AES on admission? |
Final case classification for patients with AESc | |||||
---|---|---|---|---|---|---|---|---|
No |
Yes |
|||||||
Children | Adults | Children | Adults | |||||
Encephalitis | JEV | 6 | 0 | 35 | 9 | Laboratory-confirmed JE | ||
Dengue | 0 | 0 | 2 | 1 | AES – other agent | |||
Rabies | 0 | 0 | 1 | 1 | AES – other agent | |||
Unknownd | 1 | 0 | 7 | 30 | AES – unknown | |||
ADEM (post rabies vaccination) | 0 | 0 | 0 | 2 | AES – unknown | |||
Encephalopathy | Dengue (DF or DHF) | 0 | 0 | 2 | 5 | AES – other agent | ||
Typhoid | 0 | 0 | 3 | 4 | AES – other agent | |||
Malaria | 0 | 0 | 2 | 3 | AES – other agent | |||
Leptospirosis | 0 | 0 | 0 | 1 | AES – other agent | |||
Unknown | 0 | 0 | 7 | 38 | AES – unknown | |||
Sepsis – other | 0 | 0 | 1 | 11 | AES – other agent | |||
Pyogenic meningitis | Culture positive | 5 | 2 | 1 | 14 | AES – other agent | ||
Culture negative | 5 | 5 | 7 | 17 | AES – unknown | |||
JEVe | 1 | 0 | 0 | 0 | N/A | |||
Tuberculous meningitis | 1 | 10 | 7 | 28 | AES – unknown | |||
Aseptic meningitis | JEV | 4 | 0 | 0 | 0 | N/A | ||
Mumps | 0 | 1 | 0 | 0 | N/A | |||
Unknown | 1 | 5 | 0 | 0 | N/A | |||
Meningitis – fungal | 0 | 2 | 0 | 1 | AES – other agent | |||
Meningism | JEV | 2 | 0 | 0 | 0 | N/A | ||
Assoc with pneumonia | 2 | 0 | 1 | 0 | AES – unknown | |||
Assoc with other viral illness | 2 | 2 | 0 | 0 | N/A | |||
Myelitis | JEV | 6 | 0 | 0 | 0 | N/A | ||
Dengue | 1 | 1 | 0 | 0 | N/A | |||
Unknown | 2 | 0 | 2 | 1 | AES – unknown | |||
Abscess | 2 | 2 | 0 | 5 | AES – other agent | |||
Guillain-Barré syndrome | 6 | 0 | 1 | 0 | AES – unknown | |||
Complex febrile convulsion | 0 | 0 | 12 | 0 | AES – unknown | |||
Tense fontanelle | 6 | 0 | 1 | 0 | AES – unknown | |||
Non-infectious cause | 0 | 1 | 4 | 29 | AES – other agent | |||
Total | 52 | 32 | 96 | 200 |
ADEM, acute disseminated encephalomyelitis; AES, acute encephalitis syndrome; DF, dengue fever; DHF, dengue haemorrhagic fever; JE, Japanese encephalitis; JEV, Japanese encephalitis virus; N/A, not applicable. a Clinical diagnostic group was based on the initial clinical and (cerebrospinal fluid) CSF findings. b Etiology is that determined after investigations were completed. c Laboratory-confirmed JE patients meet AES case definition on admission; AES – other agent, if an alternative agent or non-infectious cause was identified; AES – unknown, if no definite cause identified. d One JEV-negative child presented with fever, focal neurological signs, but no loss of consciousness and had encephalitis diagnosed on computed tomography. e One child with a neck stiffness, and extensor plantars, had a CSF white-cell count of 200/ml, 55% neutrophils, a glucose ratio of 53% and protein of 63.5 mg/dl was diagnosed clinically as having pyogenic meningitis, but CSF bacterial cultures were negative, and the CSF was positive for JEV IgM antibody.