Table 1.
Clinical and Laboratory Findings in 11 Patients Hospitalized with Encephalitis in Panama, 2010.*
| Patient No. |
Location | Age | Sex | Date at Illness Onset |
Signs and Symptoms |
Cause | Days Hospitalized |
White-Cell Count | CSF | Sample Day and Type† |
IgM ELISA | PRNT Titer‡ | RT-PCR | Viral Culture |
Outcome | ||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Protein | Glucose | White Cells | |||||||||||||||
| yr | no. |
per mm2
(% neutrophils) |
mg/dl |
per mm2
(% monocytes) |
|||||||||||||
| 247134 | Rio Iglesias | 9 | Male | May 29 | Fever, headache, vomit ing, seizures, status epilepticus |
EEEV | 12 | 19,500 (96) | 274 | 69 | 146 (97) | 6, serum |
Positive for EEEV, negative for VEEV |
EEEV = 40; VEEV <20 |
ND | ND | Left hemiparesis |
| 12, serum |
Positive for EEEV, negative for VEEV |
ND | ND | ND | |||||||||||||
| 44, serum |
Negative for EEEV and VEEV |
ND | ND | ND | |||||||||||||
| 247135 | Meteti | 2 | Male | May 31 | Fever, seizures, status epilepticus |
EEEV | 22 | 19,100 (82) | 67 | 62 | 387 (72) | 6, serum |
Positive for EEEV, negative for VEEV |
EEEV = 80, VEEV <20 |
ND | ND | Right hemiparesis, psy chomotor retarda tion, impaired exec utive functioning |
| 23, serum |
Positive for EEEV, negative for VEEV |
ND | ND | ND | |||||||||||||
| 55, serum |
Negative for EEEV and VEEV |
ND | ND | ND | |||||||||||||
| 247220 | Rio Iglesias | 2 | Female | June 6 | Fever, headache, vomiting, somnolence or altered mental status |
EEEV | 8 | NA | NA | NA | NA | 4, serum |
Positive for EEEV, negative for VEEV |
ND | ND | ND | NA |
| 49, serum |
Negative for EEEV andVEEV | ND | ND | ND | |||||||||||||
| 247550 | Santa Rosa | 2 | Female | June 6 | Fever, vomiting, seizures, status epilepticus, som nolence or altered men tal status, dehydration |
EEEV | 21 | 9000 (75) | 30 | 57 | 30 (72) | 3, CSF |
Negative for EEEV and VEEV |
ND | Negative | Negative¶ | Seizures, psychomotor retardation, spastic quadriparesis |
| 3, serum |
Positive for EEEV, negative for VEEV |
ND | Negative | Negative | |||||||||||||
| 15, serum |
Positive for EEEV, negative for VEEV |
EEEV = 320, VEEV <20 |
ND | ND | |||||||||||||
| 44, serum§ |
Negative for EEEV and VEEV |
EEEV = 320, VEEV <20 |
ND | ND | |||||||||||||
| 247551 | Yaviza | 1 | Male | June 6 | Fever, vomiting, seizures, diarrhea, status epilep ticus, dehydration |
EEEV | 20 | 24,000 (11) | >300 | 141 | 0 | 6, serum |
Positive for EEEV, negative for VEEV |
ND | ND | ND | Seizures |
| 21, serum |
Positive for EEEV, negative for VEEV |
EEEV = 640, VEEV = 0 |
ND | ND | |||||||||||||
| 54, serum |
Positive for EEEV, negative for VEEV |
EEEV = 640, VEEV = 0 |
ND | ND | |||||||||||||
| 247419 | Yaviza | 13 | Male | June 15 | Fever, headache, vomiting, somnolence or altered mental status |
EEEV and VEEV |
5 | 4100 (80) | 19 | 56 | 3 (NA) | 1, serum |
Negative for EEEV and VEEV |
EEEV = 0, VEEV = 0 |
Negative | VEE virus |
None |
| 2, serum |
Negative for EEEV and VEEV |
EEEV = 40, VEEV = 0 |
Alphavirus | VEE virus |
|||||||||||||
| 40, serum |
Positive for EEEV, negative for VEEV |
EEEV = 40, VEEV = 80 |
ND | ND | |||||||||||||
| 247801 | Chepigana | 3 | Male | June 19 | Fever, headache, vomiting, somnolence or altered mental status |
VEEV | 5 | 8700 (88) | 21 | 80 | 2 (100) | 1, serum |
Negative for EEEV and VEEV |
ND | ND | ND | None |
| 12, serum |
Negative for EEEV, positive for VEEV |
ND | ND | ND | |||||||||||||
| 36, serum |
Negative for EEEV, positive for VEEV |
EEEV = 0, VEEV = 80 |
ND | ND | |||||||||||||
| 247747 | El Real | 10 | Male | June 22 | Fever, headache, vomiting, seizures, diarrhea |
EEEV | 3 | NA | NA | NA | NA | 1, serum |
ND | EEEV = 0, VEEV = 0 |
ND | ND | None |
| 6, serum |
Positive for EEEV, negative for VEEV |
ND | ND | ND | |||||||||||||
| 247752 | Meteti | 18 | Male | June 26 | Fever, headache, somno lence or altered mental status, cough, he- matemesis, shock |
VEEV | NA | ND | ND | ND | ND | 1, serum |
ND | ND | Alphavirus | VEEV | Death |
| 247921 | Santa Fe | 2 | Male | June 26 | Fever, seizures | EEEV | 8 | 17,800 (72) | 53 | 66 | 272 (75) | 4, serum |
Positive for EEEV, negative for VEEV |
EEEV = 20, VEEV = 0 |
ND | ND | None |
| 18, serum§ |
Positive for EEEV, negative for VEEV |
EEEV >640, VEEV=0 |
ND | ND | |||||||||||||
| 29, serum§ |
Negative for EEEV andVEEV |
ND | ND | ND | |||||||||||||
| 248036 | Yaviza | 4 | Male | June 29 | Fever, headache, vomiting, seizures |
VEEV | 3 | 12,400 (29) | ND | ND | ND | 1, serum§ |
Negative for EEEV andVEEV |
ND | ND | ND | Seizures |
| 7, serum§ |
Negative for EEEV andVEEV |
ND | ND | ND | |||||||||||||
| 26, serum§ |
Negative for EEEV, positive for VEEV |
EEEV = 0, VEEV = 80 |
ND | ND | |||||||||||||
*
CSF denotes cerebrospinal fluid, EEEV eastern equine encephalitis virus, ELISA enzyme-linked immunosorbent assay, NA not available, ND not done, PRNT plaque-reduction neutralization test, RT-PCR reverse-transcriptase–polymerase chain reaction, and VEEV Venezuelan equine encephalitis virus. To convert the values for glucose to millimoles per liter, multiply by 0.05551.
†
Numbers indicate the number of days from the onset of illness to sample collection.
‡
The titer is the reciprocal of the end-point dilution yielding 80% plaque reduction.
§
Seroconversion from IgG-negative to IgG-positive.
¶
In this patient there was a cytopathic effect due to a virus other than an alphavirus.