Table 1.
Patient characteristics and clinical presentation
| Parameter | Encephalitis (n = 10) | ASM (n = 25) | ABM (n = 6) | Controls (n = 42) | p valuea |
|---|---|---|---|---|---|
| Gender, males (%) | 4 (40) | 10 (40) | 4 (67) | 13 (31) | 0.385 |
| Age, years | 43.5 (30, 72) | 35 (28, 48) | 52 (41, 68) | 31 (22, 41) | 0.054 |
| Hospital stay, days | 19 (11, 42)b | 3 (1.5, 5.5)c | 19 (14, 33)b, d | 2.0 (1.0, 4.0) | < 0.001 |
| Comorbidity (%) | |||||
| Immunodeficiencye | 2 (30)b | 1 (4)c | 1 (17)b | – | 0.029 |
| Psychiatric disorder | 2 (20)b | 2 (8) | – | – | 0.046 |
| Etiology known (%)f | 4/10 (40) | 16/25 (64) | 6/6 (100) | – | < 0.001 |
| Headache (%) | 7/10 (70)b | 24/25 (96)c | 3/4 (75) | 39/41 (95) | 0.037 |
| Neck stiffness (%)g | 2/10 (20) | 12/25 (48) | 3/5 (60) | 12/42 (29) | 0.175 |
| Objective fever (%)h | 7/10 (70) | 17/25 (68) | 5/6 (83) | 20/42 (48) | 0.168 |
| Focal neurology (%) | 5/9 (56)b | 2/19 (10)c | 1/6 (17) | 1/24 (4) | 0.003 |
| GCS ≤ 14 (%) | 10/10 (100)b | 2/25 (8)c | 5/6 (83)b,d | 6/42 (14) | < 0.001 |
| CSF WBC (× 106/L) | 25 (9.5, 92)b | 179 (26, 271)b, c | 212 (91, 1434)b, c | 1.0 (1.0, 2.0) | < 0.001 |
| CSF protein (g/L) | 0.57 (0.4, 0.9)b | 0.59 (0.4, 0.8)b | 2.2 (0.8, 5.9)b, c, d | 0.26 (0.2, 0.3) | < 0.001 |
| CSF glucose (mmol/L) | 3.6 (3.3, 4.4) | 3.5 (3.0, 3.7) | 3.6 (0.4, 6.3) | 3.5 (3.2, 3.7) | 0.341 |
| Glucose ratio | 0.6 (0.5, 0.7) | 0.6 (0.5, 0.6)b | 0.4 (0.1, 0.6)b | 0.6 (0.6, 0.7) | 0.009 |
| Albumin ratio | 8.4 (6.5,14)b | 9.4 (6.1, 13)b | 79 (36, 137)b, c, d | 4.0 (2.6, 5.0) | < 0.001 |
| Blood WBC (× 109/L) | 8.6 (7.4, 11) | 8.2 (6.1, 11) | 14 (8.5, 18) | 10 (6.7, 12) | 0.173 |
| CRP, serum (mg/L) | 6 (0.9, 86) | 3.5 (1.3, 12)b | 169 (96, 446)b, c, d | 16 (2.1, 77) | 0.001 |
CSF WBC white blood cell count in CSF, glucose ratio CSF glucose/serum glucose, albumin ratio CSF albumin/serum albumin. Significant p-values are marked in bold.
Data shown are median (IQR) or numbers/n (%)
ap values for one way analysis of variance (Kruskal-Wallis)
bp < 0.05 for analysis with Mann-Whitney U test (MWU) in comparison with the control group
cp < 0.05 for analysis with MWU in comparison with encephalitis
dp < 0.05 for analysis with MWU in comparison with ASM
eUnder treatment for or treated for cancer within the last year (including hematological malignancies), HIV infection or diabetes mellitus type 2 (DM2), or using immunosuppressive or immune modulating drugs
fCausing agents for encephalitis were 3 viral (adenovirus, HSV1, VZV) and 1 NMDAr encephalitis. ABM; Streptococcus pneumonia (n = 2), Staphylococcus aureus (n = 2), Neisseria meningitides (n = 1), and Haemophilus influenzae (n = 1). ASM; HSV2 (n = 6), enterovirus (n = 8), Toscana virus (n = 1), and 1 patient had intrathecal antibody production of IgG against Borrelia burgdorferi
gNeck stiffness was assessed by a physician before LP
hFever was defined as either ≥ 38 °C upon admission or within 24 h after admission, or measured to ≥ 38 °C by the patient prior to admission