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Childhood Infectious Encephalitis: An Overview of Clinical Features, Investigations, Treatment, and Recent Patents

[ Vol. 14 , Issue. 2 ]

Author(s):

Cheuk C. Au, Kam L. Hon*, Alexander K.C. Leung and Alcy R. Torres   Pages 156 - 165 ( 10 )

Abstract:


Background: Infectious encephalitis is a serious and challenging condition to manage. This overview summarizes the current literature regarding the etiology, clinical manifestations, diagnosis, management, and recent patents of acute childhood infectious encephalitis.

Methods: We used PubMed Clinical Queries as a search engine and used keywords of “encephalitis” AND “childhood” Patents were searched using the key term “encephalitis” in google.patents.- com and patentsonline.com.

Results: Viral encephalitis is the most common cause of acute infectious encephalitis in children. In young children, the clinical manifestations can be non-specific. Provision of empiric antimicrobial therapy until a specific infectious organism has been identified, which in most cases includes acyclovir, is the cornerstone of therapy. Advanced investigation tools, including nucleic acid-based test panel and metagenomic next-generation sequencing, improve the diagnostic yield of identifying an infectious organism. Supportive therapy includes adequate airway and oxygenation, fluid and electrolyte balance, cerebral perfusion pressure support, and seizure control. Recent patents are related to the diagnosis, treatment, and prevention of acute infectious encephalitis.

Conclusion: Viral encephalitis is the most common cause of acute infectious encephalitis in children and is associated with significant morbidity. Recent advances in understanding the genetic basis and immunological correlation of infectious encephalitis may improve treatment. Third-tier diagnostic tests may be incorporated into clinical practice. Treatment is targeted at the infectious process but remains mostly supportive. However, specific antimicrobial agents and vaccines development is ongoing.

Keywords:

Antimicrobial therapy, vaccine, coma, headache, impaired consciousness, seizure, infectious encephalitis, metagenomic next-generation sequencing.

Affiliation:

Department of Paediatrics and Adolescent Medicine, The Hong Kong Children’s Hospital, Kowloon Bay, Kowloon, Department of Paediatrics and Adolescent Medicine, The Hong Kong Children’s Hospital, Kowloon Bay, Kowloon, Department of Pediatrics, The University of Calgary and The Alberta Children’s Hospital, Calgary, Alberta, Department of Pediatrics, Division of Pediatric Neurology, Pediatric Traumatic Brain Injury Program, Associate Professor of Pediatrics and Neurology, Boston University, School of Medicine, Boston, MA



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