Pediatric Enterovirus Encephalitis: Clinical, Neuroimaging, and Prognostic Insights From a Single-Center Study in the UAE

Enteroviral encephalitis in children is rare but can lead to severe neurological complications. This study describes the clinical, neuroimaging, and laboratory features of pediatric enteroviral encephalitis at Burjeel Hospital, Abu Dhabi, and explores, in an exploratory and hypothesis-generating manner, associations between clinical findings, laboratory results, neuroimaging, and patient outcomes. This is a small descriptive case series (n = 9), and all findings should be interpreted accordingly. A retrospective study included nine pediatric patients with enteroviral encephalitis confirmed by CSF PCR; other etiologies were excluded per predefined inclusion and exclusion criteria. The median age was five years, with a male predominance (n = 7; 77.8%). Symptoms included fever (9/9; 100%), vomiting (8/9; 88.9%), headache (7/9; 77.8%), and neck stiffness (7/9; 77.8%). Seizures occurred in one patient (1/9; 11.1%). Total hospital stays ranged from 2 to 15 days (median three days); PICU stays ranged from 1 to 12 days (median one day). As an exploratory observation, neuroimaging abnormalities showed an association with prolonged PICU stays (rs = 0.694, p = 0.038) and adverse outcomes, while CRP levels did not (rs =− 0.548, p = 0.127); these are hypothesis-generating findings only and not confirmatory. One patient (1/9; 11.1%) with ALERD on MRI had the most severe outcome, including long-term neurological sequelae. Eight of nine patients (8/9; 88.9%) achieved full neurological recovery with supportive care alone. This exploratory case series suggests a potential role for early neuroimaging in clinical decision-making and contributes region-specific data from the UAE. Prospective multicenter studies are required to validate these observations.