Abstract|Neuro Critical Care 1| Volume 357, SUPPLEMENT 1, e60, October 15, 2015

Spectrum of acute encephalitis syndrome in an intensive care unit: an experience from a tertiary care center from India

      Background: There is paucity of studies evaluating the spectrum and outcome of the patients with acute encephalitis syndrome (AES) in intensive care unit (ICU).
      Objective: This study reports the spectrum of AES in ICU, and their predictors of mechanical ventilation (MV), death and functional outcome.
      Material and methods: The AES patients admitted to the neurology ICU were prospectively included and their demographic details, clinical, hematological, biochemical, MRI findings and etiology were noted. Death during hospitalization, complications and functional outcome at 3 months was noted.
      Results: 164 out of 258 (64%) AES patients needed ICU admission. Their median age was 35 (2-85) years and 71 (43%) were females. The etiology was viral in 44 (Herpes and Japanese encephalitis in 12 each, dengue in 17, mumps, measles and varicella in 1 patient each), non -viral in 64 (scrub typhus in 48, falciparum malaria in 6, leptospira in 3, and bacterial in 7), and undiagnosed in 56 (34%). 69 (42%) patients needed MV. On multivariate analysis, Glasgow Coma Scale (GCS) score, SOFA score, thrombocytopenia, raised intracranial pressure and pneumonia on admission were independent predictors of MV. 43 (26%) patients died, and all were in the MV group. SOFA score, untreatable etiology, GCS score, focal weakness and seizures were independent predictors of mortality. At 3 months, 14% had poor and 86% had good outcome. GCS scores, focal weakness and status epilepticus independently predicted poor outcome.
      Conclusion: 26% AES patients in ICU died and depth of coma was the constant predictor for MV, death and poor outcome.