Clinical profile and outcome of patients with acute febrile encephalopathy: a prospective study from tertiary care teaching hospital

Abstract

Acute febrile encephalopathy (AFE) is a common cause of hospital admissions in north Karnataka. It is a clinical term used to describe altered mental state that either accompanies or follows a short febrile illness and is characterized by a diffuse and nonspecific brain insult manifested by a combination of CNS manifestations. The objective of the study is to identify the etiological diagnosis and outcome in adult patients with AFE. A prospective observational study over a period of 1 year in patients aged 15 years or above who were admitted with AFE at a tertiary care center (Jan2012 to Dec 2012). AFE diagnosis was done after excluding the non-infectious causes of loss of consciousness. To determine the possible etiology Cerebrospinal fluid (CSF) analysis and imaging of brain was done. Of the total 100 patients studied, acute viral encephalitis (AVE) was the most common etiology (34%), followed by sepsis associated encephalopathy (SAE) (29%), pyogenic meningitis (PM)(22%). Cerebral malaria (CM) and tuberculous meningitis (TM) was diagnosed in 6%, and 5% of cases, respectively. In this study, acute viral encephalitis was the common etiology followed by sepsis associated encephalopathy and pyogenic meningitis. Our study demonstrates that acute febrile encephalopathy in adults is a heterogeneous syndrome with primary CNS infections being the commonest etiology