Determining the clinical characteristics and prognostic factors for the outcomes of Japanese encephalitis in adults: A multicenter study from southern Taiwan

Shih Hao Lo, Hung Jen Tang, Susan Shin Jung Lee, Jen Chieh Lee, Jien Wei Liu, Wen Chien Ko, Ko Chang, Chun Yuan Lee, Ya Ting Chang, Po Liang Lu

研究成果: Article

摘要

Background: In Southeast Asia, Japanese encephalitis (JE) is an important cause of viral encephalitis which may cause severe neurological sequelae. JE affects mostly children; therefore, clinical presentations and prognosis of adult JE patients are seldom addressed. This study aimed to describe the clinical characteristics and prognostic factors for the outcome of adult JE patients. Methods: Medical records of adult JE patients with acute encephalitis syndrome during 2001–2018 from five medical centers in southern Taiwan were reviewed. Clinical characteristics, brain images, and prognostic factors for outcomes were analyzed. Patients were divided into the good outcome (GO) group and poor outcome (PO) group according to their Glasgow Coma Scale (GCS) scores (GCS >8 vs. ≤ 8) at discharge. Results: Sixty-eight patients (men, 61.8%; median age, 50 years) were included. Summer is the epidemic season, and the number of cases peaked in June. The most common symptoms at initial presentation were altered consciousness and fever (both 94.1%), followed by headache (51.4%). The most commonly involved brain regions were thalamus (55.7%) and basal ganglion (37.7%). The median GCS score at nadir was 8, and the median time from onset to nadir was five days. Fifty-two patients were included in the GO group, while 16 were included in the PO group. On multivariate analysis, flaccidity, rigidity, and elevated CSF protein level were identified as independent prognostic factors for PO. Conclusion: Initial clinical presentations of abnormal muscle tone including flaccidity, rigidity and high CSF protein levels are independent prognostic factors for PO in adult JE patients.

原文English
頁(從 - 到)893-901
頁數9
期刊Journal of Microbiology, Immunology and Infection
52
發行號6
DOIs
出版狀態Published - 2019 十二月

指紋

Japanese Encephalitis
Taiwan
Multicenter Studies
Glasgow Coma Scale
Viral Encephalitis
Southeastern Asia
Brain
Basal Ganglia
Consciousness
Thalamus
Medical Records
Headache
Proteins
Fever
Multivariate Analysis
Muscles

All Science Journal Classification (ASJC) codes

  • Immunology and Allergy
  • Immunology and Microbiology(all)
  • Microbiology (medical)
  • Infectious Diseases

引用此文

Lo, Shih Hao ; Tang, Hung Jen ; Lee, Susan Shin Jung ; Lee, Jen Chieh ; Liu, Jien Wei ; Ko, Wen Chien ; Chang, Ko ; Lee, Chun Yuan ; Chang, Ya Ting ; Lu, Po Liang. / Determining the clinical characteristics and prognostic factors for the outcomes of Japanese encephalitis in adults : A multicenter study from southern Taiwan. 於: Journal of Microbiology, Immunology and Infection. 2019 ; 卷 52, 編號 6. 頁 893-901.
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title = "Determining the clinical characteristics and prognostic factors for the outcomes of Japanese encephalitis in adults: A multicenter study from southern Taiwan",
abstract = "Background: In Southeast Asia, Japanese encephalitis (JE) is an important cause of viral encephalitis which may cause severe neurological sequelae. JE affects mostly children; therefore, clinical presentations and prognosis of adult JE patients are seldom addressed. This study aimed to describe the clinical characteristics and prognostic factors for the outcome of adult JE patients. Methods: Medical records of adult JE patients with acute encephalitis syndrome during 2001–2018 from five medical centers in southern Taiwan were reviewed. Clinical characteristics, brain images, and prognostic factors for outcomes were analyzed. Patients were divided into the good outcome (GO) group and poor outcome (PO) group according to their Glasgow Coma Scale (GCS) scores (GCS >8 vs. ≤ 8) at discharge. Results: Sixty-eight patients (men, 61.8{\%}; median age, 50 years) were included. Summer is the epidemic season, and the number of cases peaked in June. The most common symptoms at initial presentation were altered consciousness and fever (both 94.1{\%}), followed by headache (51.4{\%}). The most commonly involved brain regions were thalamus (55.7{\%}) and basal ganglion (37.7{\%}). The median GCS score at nadir was 8, and the median time from onset to nadir was five days. Fifty-two patients were included in the GO group, while 16 were included in the PO group. On multivariate analysis, flaccidity, rigidity, and elevated CSF protein level were identified as independent prognostic factors for PO. Conclusion: Initial clinical presentations of abnormal muscle tone including flaccidity, rigidity and high CSF protein levels are independent prognostic factors for PO in adult JE patients.",
author = "Lo, {Shih Hao} and Tang, {Hung Jen} and Lee, {Susan Shin Jung} and Lee, {Jen Chieh} and Liu, {Jien Wei} and Ko, {Wen Chien} and Ko Chang and Lee, {Chun Yuan} and Chang, {Ya Ting} and Lu, {Po Liang}",
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Determining the clinical characteristics and prognostic factors for the outcomes of Japanese encephalitis in adults : A multicenter study from southern Taiwan. / Lo, Shih Hao; Tang, Hung Jen; Lee, Susan Shin Jung; Lee, Jen Chieh; Liu, Jien Wei; Ko, Wen Chien; Chang, Ko; Lee, Chun Yuan; Chang, Ya Ting; Lu, Po Liang.

於: Journal of Microbiology, Immunology and Infection, 卷 52, 編號 6, 12.2019, p. 893-901.

研究成果: Article

TY - JOUR

T1 - Determining the clinical characteristics and prognostic factors for the outcomes of Japanese encephalitis in adults

T2 - A multicenter study from southern Taiwan

AU - Lo, Shih Hao

AU - Tang, Hung Jen

AU - Lee, Susan Shin Jung

AU - Lee, Jen Chieh

AU - Liu, Jien Wei

AU - Ko, Wen Chien

AU - Chang, Ko

AU - Lee, Chun Yuan

AU - Chang, Ya Ting

AU - Lu, Po Liang

PY - 2019/12

Y1 - 2019/12

N2 - Background: In Southeast Asia, Japanese encephalitis (JE) is an important cause of viral encephalitis which may cause severe neurological sequelae. JE affects mostly children; therefore, clinical presentations and prognosis of adult JE patients are seldom addressed. This study aimed to describe the clinical characteristics and prognostic factors for the outcome of adult JE patients. Methods: Medical records of adult JE patients with acute encephalitis syndrome during 2001–2018 from five medical centers in southern Taiwan were reviewed. Clinical characteristics, brain images, and prognostic factors for outcomes were analyzed. Patients were divided into the good outcome (GO) group and poor outcome (PO) group according to their Glasgow Coma Scale (GCS) scores (GCS >8 vs. ≤ 8) at discharge. Results: Sixty-eight patients (men, 61.8%; median age, 50 years) were included. Summer is the epidemic season, and the number of cases peaked in June. The most common symptoms at initial presentation were altered consciousness and fever (both 94.1%), followed by headache (51.4%). The most commonly involved brain regions were thalamus (55.7%) and basal ganglion (37.7%). The median GCS score at nadir was 8, and the median time from onset to nadir was five days. Fifty-two patients were included in the GO group, while 16 were included in the PO group. On multivariate analysis, flaccidity, rigidity, and elevated CSF protein level were identified as independent prognostic factors for PO. Conclusion: Initial clinical presentations of abnormal muscle tone including flaccidity, rigidity and high CSF protein levels are independent prognostic factors for PO in adult JE patients.

AB - Background: In Southeast Asia, Japanese encephalitis (JE) is an important cause of viral encephalitis which may cause severe neurological sequelae. JE affects mostly children; therefore, clinical presentations and prognosis of adult JE patients are seldom addressed. This study aimed to describe the clinical characteristics and prognostic factors for the outcome of adult JE patients. Methods: Medical records of adult JE patients with acute encephalitis syndrome during 2001–2018 from five medical centers in southern Taiwan were reviewed. Clinical characteristics, brain images, and prognostic factors for outcomes were analyzed. Patients were divided into the good outcome (GO) group and poor outcome (PO) group according to their Glasgow Coma Scale (GCS) scores (GCS >8 vs. ≤ 8) at discharge. Results: Sixty-eight patients (men, 61.8%; median age, 50 years) were included. Summer is the epidemic season, and the number of cases peaked in June. The most common symptoms at initial presentation were altered consciousness and fever (both 94.1%), followed by headache (51.4%). The most commonly involved brain regions were thalamus (55.7%) and basal ganglion (37.7%). The median GCS score at nadir was 8, and the median time from onset to nadir was five days. Fifty-two patients were included in the GO group, while 16 were included in the PO group. On multivariate analysis, flaccidity, rigidity, and elevated CSF protein level were identified as independent prognostic factors for PO. Conclusion: Initial clinical presentations of abnormal muscle tone including flaccidity, rigidity and high CSF protein levels are independent prognostic factors for PO in adult JE patients.

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