Burden of central nervous system infection in cases of fever with seizure and its association with outcome: an experience in a tertiary care center of Uttarakhand, India


  • Ramesh Chand Department of Pediatrics, Government Medical College, Haldwani, Nainital, Uttarakhand, India
  • Yuvraj Sharma Department of Pediatrics, Government Medical College, Haldwani, Nainital, Uttarakhand, India
  • Ritu Rakholia Department of Pediatrics, Government Medical College, Haldwani, Nainital, Uttarakhand, India




Acute febrile encephalopathy, Central nervous system infection, Encephalitis, Meningitis, Seizure


Background: CNS infections have been linked to adverse neurological sequelae notably seizures and mortality. Although, various etiologies of AFE have been studied, but the mystery still remains untangled for the substantial risk factors for the diagnosis and outcome.

Methods: This prospective study was carried out on 67 children between 2 months to 15 years, from (May 2016 to April 2017) tertiary care centre of Uttarakhand. Patients were analysed for demographic variables, haematological parameters, CSF analysis, neuroimaging and their outcome was assessed at one month of follow up.

Results: This study showed, 70% (n=47) of the cases presented in acute febrile encephalopathy. Most cases were diagnosed with pyogenic meningitis (40%, n=27) and More commonly occur during rainy season (39%; n=26) radiologically meningeal enhancement (28%; n=18) as the most common finding. Cases of acute febrile encephalopathy with GCS ≤5 had significant association with mortality. (Fischer exact value of 0.005; significant at p<0.05).

Conclusions: Clinical signs of meningitis are not always reliable, and a laboratory support is required to reach early diagnosis hence. Pseudomonas and MRCONS were the major pathogens responsible for the bacterial meningitis among the paediatric age groups, hence antibiotic management should be planned intensively while culture reports are awaited. Cluster of cases with meningoencephalitis were found in rainy season hence suggested possible etiologies are JE/ Scrub/ Enterovirus. Mortality as well as morbidity was high in cases with acute encephalitis syndrome cause? JE/unknown etiology in this era for modern medicine hence vector control strategies be encouraged.


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