Abstract Background: Acute encephalitis syndrome (AES) is a major cause of morbidity and mortality among children in developing countries, including India. It encompasses a broad spectrum of infectious and noninfectious etiologies, with viral infections such as Japanese encephalitis (JE), herpes simplex virus (HSV), and enteroviruses being common causes. Despite extensive surveillance, the etiological agent remains unidentified in many cases, posing challenges in clinical management and prevention. Our objective was to study the etiology, clinical and laboratory profile, and outcomes of AES in children admitted to a tertiary care center in eastern India. Materials and Methods: This cross-sectional study was conducted from September 2023 to February 2025 at SCB Medical College and Sardar Vallabhbhai Patel Post Graduate Institute of Pediatrics, Cuttack. Children aged from 1 month to 14 years fulfilling the World Health Organization definition of AES were included. Clinical, laboratory, and virological data were collected using a structured proforma. Cerebrospinal fluid (CSF) analysis and viral testing using immunoglobulin M enzyme-linked immunosorbent assay and polymerase chain reaction were performed. Statistical analysis was done using Statistical Package for the Social Sciences version 25. Results: A total of 168 children were enrolled. The highest incidence was observed in the 5–10 years age group (35.7%), with male predominance (58.9%). Fever (100%), altered sensorium (76.2%), and seizures (59.5%) were the most common presentations. Viral etiology was identified in 6.6% cases, including JE (54.5%), HSV-1 (27.3%), and enterovirus (18.2%). Intensive care unit admission was required in 67.9%, and mechanical ventilation in 44.6%. Overall mortality was 33.3%. Low Glasgow Coma Scale score, elevated CSF protein, elevated CRP, and mechanical ventilation requirement were significantly associated with mortality. Conclusion: AES remains associated with high mortality and morbidity. Early recognition, aggressive supportive care, and strengthening diagnostic and preventive strategies, including JE vaccination and surveillance, are critical to improving outcomes.
Augustus et al. (Thu,) studied this question.