AJTMH Transactions of the Royal Society of Tropical Medicine and Hygiene
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Am. J. Trop. Med. Hyg., 34(6), 1985, pp. 1203-1210
Copyright © 1985 by The American Society of Tropical Medicine and Hygiene

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Fatal Outcome in Japanese Encephalitis

Donald S. Burke, Wanida Lorsomrudee, Colin J. Leake, Charles H. Hoke, Ananda Nisalak, Virojana Chongswasdi AND Thanom Laorakpongse
Department of Virology, U.S. Component, Armed Forces Research Institute of Medical Sciences, Rajvithi Road, Bangkok 10400, Thailand, and the Kampangphet Provincial Hospital, Kampangphet, Thailand

Forty-nine consecutive patients with laboratory-confirmed acute Japanese encephalitis were studied to identify risk factors present at hospital admission which were associated with a fatal outcome. Sixteen patients (33%) died. The following constellation of findings correlated with a fatal outcome: infectious virus in cerebrospinal fluid (CSF), low levels of Japanese encephalitis virus-specific IgG and IgM in both CSF and serum, and a severely depressed sensorium. Age, sex, days ill before admission, distance from home to the hospital, past medical history, CSF protein content, and CSF leukocyte count were not significant risk factors.

Among patients hospitalized for acute Japanese encephalitis, a vigorous virus-specific immunoglobulin response, both systemically and locally within the central nervous system, is a good marker for survival, and may be an inherently important factor in recovery from illness.

Accepted for publication May 24, 1985.




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Copyright © 1985 by the American Society of Tropical Medicine and Hygiene.