Clinical Features Of589Children With Viral Encephalitis

Objective：To retrospectively analyze the clinical features of children with Viralencephalitis (VE)，and to guide clinicians to know the features of VE indifferent regions, to achieve a better therapeutic effect.Methods：Collected and retrospectively analyzed the clinical data of589childrenwith VE in Children’s Hospital of Chongqing Medical University in January2011to December2012。Results：1. A total of589children distributed in7months to15years old wereadmitted for analysis. The mean age was5.60±3.37years, the median agewas5.00years and the male to female ratio was1.44:1.2.422children (71.6%) were from Chongqing area,160children(27.2%) were from Yunnan, Guizhou, and Sichuan provinces, and7(1.2%)children were from the other areas.269children (45.7%) were from cities and towns,320children (54.3%) were from countryside.3. This group of patients got sick with VE throughout the year, but therewas a central tendency around July.4. The most common clinical manifestations of VE were fever（78.6%）,vomiting（68.3%）, headache（52.8%）,impaired consciousness（38.7%）, cough（38.4%）, and convulsion（36.0%）.5. Specific IgM antibody in serum samples was positive in318/589cases（54.0%）. CV positive cases were the most（58.5%），followed byHSV（32.4%），AV（22.6%），EBV（11.0%），MEV（4.7%），MV（4.1%），RV（2.5%），CMV（2.2%）.6. Specific IgM antibody in CSF samples was positive in143/567cases（25.2%）. CV positive cases were the most（50.3%），followed byHSV（28.7%），AV（28.7%），EBV（11.2%），MEV（7.7%），MV（4.9%），RV（3.5%），CMV（2.1%）.7. Headache（60.2%VS47.0%，P＜0.05）was significantly morecommon in EVAE compared to OVAE. However, ataxia（1.1%VS6.1%，P＜0.05）and meningeal irritation signs（11.8%VS22.0%，P＜0.05）weresignificantly less common in EVAE.8. The CT was abnormal in59/269cases (21.9%), the MRI wasabnormal in102/332cases (30.7%), the MRI is better than CT(P＜0.05),and the EEG was abnormal in407/565cases (72.0%).9. Clinical cure in354cases, clinical improvement in230cases,5cases died;36cases remaining different degrees sequelae.Conclusion：CV infection rate（58.5%）is the highest in this study. Headache wassignificantly more common in enterovirus associated encephalitis（EVAE）compared to other virus associated encephalitis（OVAE）. However, ataxiaand meningeal irritation signs were significantly less common in EVAE.Specific IgM antibody detection in serum samples was with higher positiverate than in CSF samples. The CT and MRI both can help to evaluate thedisease and known the location of the lesion, but MRI is better than CT.EEG’s abnormal rate is high, it can be used for early diagnosis andmonitoring the changes of disease. All children with viral encephalitisshould be monitored for at least6to12months after discharge.