Acute febrile encephalopathy and its outcome among children in a tertiary care hospital

Anusha Deepthi C. H., Arigela Vasundhara, Sourika P., Sravya G. S.


Background: Acute febrile encephalopathy (AFE) is a common condition leading to hospitalization of children in India. Majority of the studies revealed etiology of AFE, but very few studies emphasized on predictors of mortality. This study was conducted to observe the outcome in relation to etiology and Glasgow coma score at admission.

Methods: This prospective study was carried out on 84 children between 2 months to 14 years, with fever duration of <14 days, GCS ≤12 at the time of admission and altered sensorium in the pediatric intensive care unit over a period of 18 months (December 2011 to June 2013). Patients were evaluated daily till discharge/death. Outcome was evaluated in terms of complete recovery, morbidity and mortality.

Results: In this study, AFE was higher among the age group of 6-14 years (54.7%) with most common cause being viral encephalitis (38%). Higher mortality rates were observed in CNS infections. Persistent seizures and hemiparesis were the most common causes of morbidity. GCS at initial presentation <7 was significantly associated with mortality, p value being 0.036.

Conclusions: CNS infections are the leading cause of febrile encephalopathy and also associated with high mortality. Persistent seizures and hemiparesis being most common causes of morbidity. Low GCS at the time of admission and longer duration of coma are associated with higher risk of morality. Most of the morbidities were observed in CNS infections and as most of them were curable, early institution of appropriate treatment will decrease morbidity. 


Acute febrile encephalopathy, GCS, Outcome

Full Text:



Anga G, Barnabas R, Kaminiel O, Tefurarani N, Vince J, Ripa P, et al. The aetiology, clinical presentations and outcome of febrile encephalopathy in children in Papua New Guinea. Ann Trop Paediatr. 2010;30:109-18.

Abend NS, Licht DJ. Predicting outcome in children with hypoxic ischemic encephalopathy. Pediatr Crit Care Med. 2008;9(1):32-9.

Bansal A, Singhi SC, Singhi PD, Khandelwal N, Ramesh S. Nontraumatic coma. Indian J Pediatr. 2005;72:467-73.

Bhalla A, Suri V, Varma S, Sharma N, Mahi S, Singh P, et al. Acute febrile encephalopathy in adults from Northwest India. J Emerg Trauma Shock. 2010;3:220-4.

Duke T, Riddell M, Barnabas R. The aetiology, clinical presentations and outcome of febrile encephalopathy in children. Annal Trop Paediatr: Int Child Health. 2010;30:109-18.

Singh RR, Chaudhary SK, Bhatta NK, Khanal B, Shah D. Clinical and etiological profile of acute febrile encephalopathy in Eastern Nepal. Indian J Pediatr. 2009;76(11):1109-11.

Kothari VM, Karnad DR, Bichile LS. Tropical infections in the ICU. J Assoc Physicians India. 2006;54:291-8.

Karmarkar SA, Aneja S, Khare S, Saini A, Seth A, Chauhan BK. A study of acute febrile encephalopathy with special reference to viral etiology. Indian J Pediatr. 2008 Aug;75(8):801-5.

Chaturvedi P, Kishore M. Modified Glasgow Coma Scale to predict mortality in febrile unconscious children. Indian J Pediatr. 2001 Apr;68(4):311-4.