Authors: C LópezSánchez E Sulleiro C Bocanegra S Romero G Codina I Sanz J Esperalba J Serra C Pigrau J Burgos B Almirante V Falcó
Publish Date: 2016/11/25
Volume: 36, Issue: 4, Pages: 641-648
Abstract
In this study we attempt to assess the utility of a simplified stepwise diagnostic algorithm to determinate the aetiology of encephalitis in daily clinical practice and to describe the main causes in our setting This was a prospective cohort study of all consecutive cases of encephalitis in adult patients diagnosed between January 2010 and March 2015 at the University Hospital Vall d’Hebron in Barcelona Spain The aetiological study was carried out following the proposed stepwise algorithm The proportion of aetiological diagnoses achieved in each step was analysed Data from 97 patients with encephalitis were assessed Following a simplified stepwise algorithm a definite diagnosis was made in the first step in 53 patients 55 and in 12 additional cases 12 in the second step Overall a definite or probable aetiological diagnosis was achieved in 78 of the cases Herpes virus L monocytogenes and M tuberculosis were the leading causative agents demonstrated whereas less frequent aetiologies were observed mainly in immunosuppressed patients The overall related mortality was 134 According to our experience the leading and treatable causes of encephalitis can be identified in a first diagnostic step with limited microbiological studies L monocytogenes treatment should be considered on arrival in some patients Additional diagnostic effort should be made in immunosuppressed patientsThis work has been presented in part as an oral presentation at the XVIII Congreso Nacional de la Sociedad Española de Enfermedades infecciosas y Microbiología Clínica Valencia Spain 9–11 April 2014 and as an oral session O182 at the 24th European Congress of Clinical Microbiology and Infectious Diseases Barcelona Spain 10–13 May 2014This study received no funding It was approved by the Ethics Committee of Vall d’Hebron Research Institute All patients included or their relatives gave written informed consent to use the information available in the database and medical records
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