Title |
Epidemiology and clinical outcomes of viral central nervous system infections
|
---|---|
Published in |
International Journal of Infectious Diseases, June 2018
|
DOI | 10.1016/j.ijid.2018.06.008 |
Pubmed ID | |
Authors |
Fatma Ben Abid, Mohammed Abukhattab, Hafedh Ghazouani, Obada Khalil, Ahmed Gohar, Hussam Al Soub, Muna Al Maslamani, Abdullatif Al Khal, Eman Al Masalamani, Said Al Dhahry, Samar Hashim, Faraj Howadi, Adeel A Butt |
Abstract |
Central nervous system (CNS) viral infections are an important cause of morbidity and mortality. No data are available regarding their epidemiology in Qatar. We retrospectively evaluated all cerebrospinal fluid findings from January 2011-March 2015 at Hamad Medical Corporation. Those with abnormal CSF finding were included in our study. We excluded those with missing medical records, no clinical evidence of viral CNS infection or proven bacterial, fungal or tuberculosis CNS infection. CNS clinical findings were classified as meningitis, encephalitis or myelitis. Among 7,690 patients with available CSF results, 550 cases met the inclusion criteria (meningitis 74.7%; encephalitis 25%; myelitis 0.4%). Two-thirds (65%) were male and 50% were between 16-60 years old. Viral etiology was confirmed in 38% (enterovirus, 44.3%; Epstein-Barr virus, 31%; varicella zoster virus, 12.4%). The estimated incidence was 6.4 per 100,000 population. Two persons died and the rest were discharged to home. Among those with confirmed viral etiology, 83.8% received ceftriaxone (mean duration 7.3+5.2 days), 38% received vancomycin (mean duration 2.7+5.4 days) and 38% received at least one other antibiotic. Intravenous acyclovir was continued for more than 48hours in patients with confirmed negative viral etiology (mean duration 5+5.6 days). Viral etiology is not uncommon among those evaluated for CNS infection in Qatar. Clinical outcomes are excellent in this group of patients. Antibiotics and acyclovir are overly used even when a viral etiology is confirmed. There is a need for clinician education regarding etiology and treatment of viral CNS infections. |
X Demographics
Geographical breakdown
Country | Count | As % |
---|---|---|
United States | 3 | 50% |
Venezuela, Bolivarian Republic of | 1 | 17% |
Unknown | 2 | 33% |
Demographic breakdown
Type | Count | As % |
---|---|---|
Members of the public | 3 | 50% |
Practitioners (doctors, other healthcare professionals) | 2 | 33% |
Scientists | 1 | 17% |
Mendeley readers
Geographical breakdown
Country | Count | As % |
---|---|---|
Unknown | 87 | 100% |
Demographic breakdown
Readers by professional status | Count | As % |
---|---|---|
Student > Bachelor | 14 | 16% |
Researcher | 9 | 10% |
Other | 8 | 9% |
Student > Master | 7 | 8% |
Student > Ph. D. Student | 5 | 6% |
Other | 14 | 16% |
Unknown | 30 | 34% |
Readers by discipline | Count | As % |
---|---|---|
Medicine and Dentistry | 25 | 29% |
Immunology and Microbiology | 6 | 7% |
Nursing and Health Professions | 3 | 3% |
Biochemistry, Genetics and Molecular Biology | 3 | 3% |
Pharmacology, Toxicology and Pharmaceutical Science | 3 | 3% |
Other | 12 | 14% |
Unknown | 35 | 40% |