A Study on Clinical Profile of Children with Acute Febrile Encephalopathy in a Tertiary Care Centre in Eastern Bihar.

Dr. Satish Kumar; Dr. Brajesh Kumar

Volume : VII, Issue : VI, June - 2017

A Study on Clinical Profile of Children with Acute Febrile Encephalopathy in a Tertiary Care Centre in Eastern Bihar.

Dr. Satish Kumar, Dr. Brajesh Kumar

Abstract :

Objective: To investigate the clinical and etiological profile of acute feile encephalopathy in children presenting to a tertiary care center of Eastern Bihar. Methods: 214 children (aged 1 month to 14 years) presenting to the Emergency, Pediatrics Department, Jawaharlal Nehru Medical College and Hospital, Bhagalpur with fever (> 38 degree Centigrade) of less than 2 weeks duration with altered sensorium with/ or without seizure were prospectively investigated for etiological cause. The investigations included blood and CSF counts, blood and CSF cultures, peripheral smear and serology for malarial parasite, and serology for Japanese encephalitis (JE) virus. Other investigations included EEG and CT or MRI wherever indicated. Results: The most common presenting complaints apart from fever and altered sensorium were headache and vomiting. Convulsions, neck rigidity, hypertonia, isk deep tendon reflexes, extensor plantar response and focal neurological deficits were seen in 50%, 57%, 22.4%, 28%, 39.3% and 9.3% of the subjects, respectively. The diagnoses based on clinical presentation and laboratory findings were pyogenic meningitis in 90 (42%), non JE viral encephalitis in 52 (25%), JE in 38 (18%), cereal malaria in 16 (7%), herpes encephalitis and tubercular meningitis in 8 (4%) each, and typhoid encephalopathy in 2 cases. Conclusion: Pyogenic meningitis and viral encephalitis including JE are the most common causes of acute presentation with fever and encephalopathy in Eastern Bihar. Preventive strategies towards this disease must be directed by the Health Department, so that this deadly disease and its sequalae can be prevented.