ProCite
RefWorks
Reference Manager
BibTeX
Zotero
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-
1.
2006. Guidelines for Surveillance of Acute Encephalitis Syndrome (with Special Reference to Japanese Encephalitis). Available at: https://ncvbdc.mohfw.gov.in/WriteReadData/l892s/AES_guidelines.pdf. Accessed 3 October 2024.
-
2.
Tripathy SK, Mishra P, Dwibedi B, Priyadarshini L, Das RR, 2019. Clinico-epidemiological study of viral acute encephalitis syndrome cases and comparison to nonviral cases in children from Eastern India. J Glob Infect Dis 11: 7.
-
3.
Clarke M, Newton RW, Klapper PE, Sutcliffe H, Laing I, Wallace G, 2006. Childhood encephalopathy: Viruses, immune response, and outcome. Dev Med Child Neurol 48: 294–300.
-
4.
National Center for Vector Borne Diseases Control Delhi State Wise Number of AES/JE Cases and Deaths from 2017–2023. Sham Nath Marg, Delhi: National Center for Vector Borne Disease Control (NCVBDC).
-
5.
Ravi V, Hameed SKS, Desai A, Mani RS, Reddy V, Velayudhan A, Yadav R, Jain A, Saikia L, Borthakur A, 2022. An algorithmic approach to identifying the aetiology of acute encephalitis syndrome in India: Results of a 4-year enhanced surveillance study. Lancet Glob Health 10: e685–e693.
-
6.
Solomon T, Dung NM, Kneen R, Gainsborough M, Vaughn DW, Khanh VT, 2000. Japanese encephalitis. J Neurol Neurosurg Psychiatry 68: 405–415.
-
7.
Jain P, Prakash S, Tripathi PK, Chauhan A, Gupta S, Sharma U, Jaiswal AK, Sharma D, Jain A, 2018. Emergence of Orientia tsutsugamushi as an important cause of acute encephalitis syndrome in India. PLoS Negl Trop Dis 12: e0006346.
-
8.
Damodar T, Singh B, Prabhu N, Marate S, Gowda VK, Lalitha A, Dsouza FS, Sajjan SV, Kariyappa M, Kinhal UV, 2023. Association of scrub typhus in children with acute encephalitis syndrome and meningoencephalitis, Southern India. Emerg Infect Dis 29: 711.
-
9.
Jain P, Prakash S, Khan DN, Garg RK, Kumar R, Bhagat A, Ramakrishna V, Jain A, 2017. Aetiology of acute encephalitis syndrome in Uttar Pradesh, India from 2014 to 2016. J Vector Borne Dis 54: 311–316.
-
10.
Rai A, Prasad R, Das B, Anupurba S, Singh UK, 2021. Cerebrospinal fluid Gene XPERT (CBNAAT) in children with tuberculous meningitis. J Clin Tuberc Other Mycobact Dis 24: 100255.
-
11.
Denkinger CM, Schumacher SG, Boehme CC, Dendukuri N, Pai M, Steingart KR, 2014. Xpert MTB/RIF assay for the diagnosis of extrapulmonary tuberculosis: A systematic review and meta-analysis. Eur Respir J 44: 435–446.
-
12.
Dihingia P, Choudhury D, Baruah SM, Das TK, Dutta C, 2019. A study of the clinico-etiological profile of acute encephalitis syndrome cases in a tertiary care hospital of Upper Assam with special reference to Japanese encephalitis. IMSEAR, ID: sea-202423. Available at: https://imsear.searo.who.int/handle/123456789/202423. Accessed 3 October 2024.
-
14.
Ltd. JMCP, Lepto IgM Microlisa. A 180-181, Okhla Ind. Area, Phase-1, New Delhi-110 020, INDIA. Available at: https://jmitra.co.in/product-details/leptospira-igm-microlisa/. Accessed 3 October 2024.
-
15.
Blacksell SD, Tanganuchitcharnchai A, Nawtaisong P, Kantipong P, Laongnualpanich A, Day NP, Paris DH, 2016. Diagnostic accuracy of the InBios scrub typhus detect enzyme-linked immunoassay for the detection of IgM antibodies in northern Thailand. Clin Vaccine Immunol 23: 148–154.
-
16.
Lata K, Koonwar S, Kanta C, Kalyan R, Verma SK, 2022. Prevalence of neuroleptospirosis in pediatric acute encephalitis syndrome cases: An experience of northern India tertiary care centre. Indian J Public Health Res Dev 13: 57–63.
-
17.
Ahmed BSS, Sen SS, 2021. Seroprevalance of Leptospira in Aes cases in a tertiary care hospital in South East Assam. Indian J Med Microbiol 39: S40.
-
18.
Kaur M, Singh K, Sidhu SK, Devi P, Kaur M, Soneja S, Singh N, 2018. Coinfection of chikungunya and dengue viruses: A serological study from north western region of Punjab, India. J Lab Physicians 10: 443–447.
-
19.
Yergolkar PN, Tandale BV, Arankalle VA, Sathe PS, Sudeep A, Gandhe SS, Gokhle MD, Jacob GP, Hundekar SL, Mishra AC, 2006. Chikungunya outbreaks caused by African genotype, India. Emerg Infect Dis 12: 1580.
-
20.
Badoni G, Gupta PK, Gupta P, Kaistha N, Mathuria YP, Pai MO, Kant R, 2023. Dengue-chikungunya infection in the tertiary care hospital of northern India: Cross-sectional latent class cluster analysis in viral infection. Heliyon 9: e14019.
-
21.
Das BK, Mohanty S, Sahoo PK, 2021. Association of leptospirosis and scrub typhus in acute encephalitis syndrome in a tertiary care hospital in Odisha, India. Trans R Soc Trop Med Hyg 115: 1088–1090.
-
22.
Diagnostic ELISA for detection of IgM antibodies against Dengue virus. Available at: https://main.icmr.nic.in/sites/default/files/Technology%20for%20Collaboration/NIV_DEN_kit.pdf. Accessed 3 October 2024.
-
23.
Diagnostic ELISA for detection of IgM antibodies against Chikungunya virus. Available at: https://main.icmr.nic.in/sites/default/files/Technology%20for%20Collaboration/NIV_CHIK_kit.pdf. Accessed 3 October 2024.
-
24.
Chelluboina S, Robin S, Aswathyraj S, Arunkumar G, 2019. Persistence of antibody response in chikungunya. Virusdisease 30: 469–473.
-
25.
Chien Y-W, Liu Z-H, Tseng F-C, Ho T-C, Guo H-R, Ko N-Y, Ko W-C, Perng GC, 2018. Prolonged persistence of IgM against dengue virus detected by commonly used commercial assays. BMC Infect Dis 18: 1–7.
-
26.
Innis B, Nisalak A, Nimmannitya S, Kusalerdchariya S, Chongswasdi V, Suntayakorn S, Puttisri P, Hoke C, 1989. An enzyme-linked immunosorbent assay to characterize dengue infections where dengue and Japanese encephalitis co-circulate. Am J Trop Med Hyg 40: 418–427.
-
27.
Edwards T, Signor LDCC, Williams C, Donis E, Cuevas LE, Adams ER, 2016. Co-infections with chikungunya and dengue viruses, Guatemala, 2015. Emerg Infect Dis 22: 2003–2005.
-
28.
Bhardwaj A, Atam V, Sawlani K, Himanshu D, Verma R, Verma S, 2022. Thrombocytopenia as a prognostic marker in patients with acute encephalitis at a tertiary care centre in northern India. J Assoc Physicians India 70: 11–12.
-
29.
Thakur KT, Motta M, Asemota AO, Kirsch HL, Benavides DR, Schneider EB, McArthur JC, Geocadin RG, Venkatesan A, 2013. Predictors of outcome in acute encephalitis. Neurology 81: 793–800.
-
30.
Kuntal M, Swarnkar K, 2020. Clinical profile and predictor of adverse outcome in children with acute encephalitis syndrome: A cross-sectional study. J Krishna Inst Med Sci University 9: 18–26.
-
31.
Adhikari A, Gajre M, Kothari R, Chaudhari N, Sangale D, 2021. Clinical profile and outcome of children admitted with acute encephalitis syndrome. Int J Contemp Pediatrics 8: 60.
| Past two years | Past Year | Past 30 Days | |
|---|---|---|---|
| Abstract Views | 830 | 830 | 218 |
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Etiology of Acute Encephalitis Syndrome in Adults in a Tertiary Care Center in Eastern Uttar Pradesh
Tulika Kumari Rai
Tulika Kumari Rai
Department of Medicine, Institute of Medical Sciences, Banaras Hindu University, Varanasi, India;
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Jaya Chakravarty
tapadar@gmail.com
Jaya Chakravarty
Department of Medicine, Institute of Medical Sciences, Banaras Hindu University, Varanasi, India;
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Shubham Kashyap
Shubham Kashyap
Department of Medicine, Institute of Medical Sciences, Banaras Hindu University, Varanasi, India;
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Sumeet Chatterjee
Sumeet Chatterjee
Department of Medicine, Institute of Medical Sciences, Banaras Hindu University, Varanasi, India;
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Vishwa Deepak Tiwari
Vishwa Deepak Tiwari
Department of Medicine, Institute of Medical Sciences, Banaras Hindu University, Varanasi, India;
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Urvashi Geeta Rai
Urvashi Geeta Rai
Department of Medicine, Institute of Medical Sciences, Banaras Hindu University, Varanasi, India;
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Mayank Gangwar
Mayank Gangwar
Clinical Studies and Trials Unit, Division of Development Research, Indian Council of Medical Research, New Delhi, India;
Department of Microbiology, Institute of Medical Sciences, Banaras Hindu University, Varanasi, India
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Department of Microbiology, Institute of Medical Sciences, Banaras Hindu University, Varanasi, India
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Shyam Sundar
Shyam Sundar
Department of Medicine, Institute of Medical Sciences, Banaras Hindu University, Varanasi, India;
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Gopal Nath
Gopal Nath
Department of Microbiology, Institute of Medical Sciences, Banaras Hindu University, Varanasi, India
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ABSTRACT.
Seasonal outbreaks of acute encephalitis syndrome (AES) with high case fatality rates have been commonly reported among adults in India. With an increase in Japanese encephalitis virus (JEV) vaccination, the etiology of AES is also changing. However, most studies on AES in India have focused only on children and on JEV. This study was conducted in the Department of Medicine, Institute of Medical Sciences, Banaras Hindu University between 2020 and 2022 to determine the etiology of AES in adults. Blood and cerebrospinal fluid (CSF) were collected from patients 18 years or older with fever and altered sensorium for ≤15 days. We did IgM ELISA for dengue, chikungunya, West Nile virus, scrub typhus, leptospirosis from serum, CSF-IgM for JEV, and CSF–polymerase chain reaction for herpes simplex virus 1 and 2, varicella-zoster virus, enterovirus, and cartridge-based nucleic acid amplification test (CBNAAT) for tuberculous meningitis (TBM). The most common cause of AES identified in our study was TBM (16.7%), followed by leptospirosis (15.1%) and scrub typhus (11.9%). The high occurrence of TBM in our study highlights the importance of CSF-CBNAAT for all AES patients. As leptospirosis and scrub typhus are easily treatable, early detection and treatment of these infections should be recommended.
- Supplemental Materials (PDF 467.51 KB)
Author Notes
Financial support: This work was supported by the Incentive Grant under
Disclosure: The study was approved by an institutional ethical committee (Dean/2019/EC/1709 and Dean/2021/EC/2964). Confidentiality and anonymity were maintained throughout the study.
Current contact information: Tulika Kumari Rai, Jaya Chakravarty, Shubham Kashyap, Sumeet Chatterjee, Vishwa Deepak Tiwari, Urvashi Geeta Rai, and Shyam Sundar, Department of Medicine, Institute of Medical Sciences, Banaras Hindu University, Varanasi, India, E-mails: tulikak.rai14@bhu.ac.in, tapadar@gmail.com, shubhamkashyapm@gmail.com, sumitchatterjeee@gmail.com, vishwadeepk@bhu.ac.in, rai.urvashi@bhu.ac.in, and drshyamsundar@hotmail.com. Mayank Gangwar, Clinical Studies and Trials Unit, Division of Development Research, Indian Council of Medical Research, New Delhi, India, E-mail: mayank.vrdl@gmail.com. Gopal Nath, Department of Microbiology, Institute of Medical Sciences, Banaras Hindu University, Varanasi, India, E-mail: gopalnath@gmail.com.
ProCite
RefWorks
Reference Manager
BibTeX
Zotero
EndNote
-
1.
2006. Guidelines for Surveillance of Acute Encephalitis Syndrome (with Special Reference to Japanese Encephalitis). Available at: https://ncvbdc.mohfw.gov.in/WriteReadData/l892s/AES_guidelines.pdf. Accessed 3 October 2024.
-
2.
Tripathy SK, Mishra P, Dwibedi B, Priyadarshini L, Das RR, 2019. Clinico-epidemiological study of viral acute encephalitis syndrome cases and comparison to nonviral cases in children from Eastern India. J Glob Infect Dis 11: 7.
-
3.
Clarke M, Newton RW, Klapper PE, Sutcliffe H, Laing I, Wallace G, 2006. Childhood encephalopathy: Viruses, immune response, and outcome. Dev Med Child Neurol 48: 294–300.
-
4.
National Center for Vector Borne Diseases Control Delhi State Wise Number of AES/JE Cases and Deaths from 2017–2023. Sham Nath Marg, Delhi: National Center for Vector Borne Disease Control (NCVBDC).
-
5.
Ravi V, Hameed SKS, Desai A, Mani RS, Reddy V, Velayudhan A, Yadav R, Jain A, Saikia L, Borthakur A, 2022. An algorithmic approach to identifying the aetiology of acute encephalitis syndrome in India: Results of a 4-year enhanced surveillance study. Lancet Glob Health 10: e685–e693.
-
6.
Solomon T, Dung NM, Kneen R, Gainsborough M, Vaughn DW, Khanh VT, 2000. Japanese encephalitis. J Neurol Neurosurg Psychiatry 68: 405–415.
-
7.
Jain P, Prakash S, Tripathi PK, Chauhan A, Gupta S, Sharma U, Jaiswal AK, Sharma D, Jain A, 2018. Emergence of Orientia tsutsugamushi as an important cause of acute encephalitis syndrome in India. PLoS Negl Trop Dis 12: e0006346.
-
8.
Damodar T, Singh B, Prabhu N, Marate S, Gowda VK, Lalitha A, Dsouza FS, Sajjan SV, Kariyappa M, Kinhal UV, 2023. Association of scrub typhus in children with acute encephalitis syndrome and meningoencephalitis, Southern India. Emerg Infect Dis 29: 711.
-
9.
Jain P, Prakash S, Khan DN, Garg RK, Kumar R, Bhagat A, Ramakrishna V, Jain A, 2017. Aetiology of acute encephalitis syndrome in Uttar Pradesh, India from 2014 to 2016. J Vector Borne Dis 54: 311–316.
-
10.
Rai A, Prasad R, Das B, Anupurba S, Singh UK, 2021. Cerebrospinal fluid Gene XPERT (CBNAAT) in children with tuberculous meningitis. J Clin Tuberc Other Mycobact Dis 24: 100255.
-
11.
Denkinger CM, Schumacher SG, Boehme CC, Dendukuri N, Pai M, Steingart KR, 2014. Xpert MTB/RIF assay for the diagnosis of extrapulmonary tuberculosis: A systematic review and meta-analysis. Eur Respir J 44: 435–446.
-
12.
Dihingia P, Choudhury D, Baruah SM, Das TK, Dutta C, 2019. A study of the clinico-etiological profile of acute encephalitis syndrome cases in a tertiary care hospital of Upper Assam with special reference to Japanese encephalitis. IMSEAR, ID: sea-202423. Available at: https://imsear.searo.who.int/handle/123456789/202423. Accessed 3 October 2024.
-
14.
Ltd. JMCP, Lepto IgM Microlisa. A 180-181, Okhla Ind. Area, Phase-1, New Delhi-110 020, INDIA. Available at: https://jmitra.co.in/product-details/leptospira-igm-microlisa/. Accessed 3 October 2024.
-
15.
Blacksell SD, Tanganuchitcharnchai A, Nawtaisong P, Kantipong P, Laongnualpanich A, Day NP, Paris DH, 2016. Diagnostic accuracy of the InBios scrub typhus detect enzyme-linked immunoassay for the detection of IgM antibodies in northern Thailand. Clin Vaccine Immunol 23: 148–154.
-
16.
Lata K, Koonwar S, Kanta C, Kalyan R, Verma SK, 2022. Prevalence of neuroleptospirosis in pediatric acute encephalitis syndrome cases: An experience of northern India tertiary care centre. Indian J Public Health Res Dev 13: 57–63.
-
17.
Ahmed BSS, Sen SS, 2021. Seroprevalance of Leptospira in Aes cases in a tertiary care hospital in South East Assam. Indian J Med Microbiol 39: S40.
-
18.
Kaur M, Singh K, Sidhu SK, Devi P, Kaur M, Soneja S, Singh N, 2018. Coinfection of chikungunya and dengue viruses: A serological study from north western region of Punjab, India. J Lab Physicians 10: 443–447.
-
19.
Yergolkar PN, Tandale BV, Arankalle VA, Sathe PS, Sudeep A, Gandhe SS, Gokhle MD, Jacob GP, Hundekar SL, Mishra AC, 2006. Chikungunya outbreaks caused by African genotype, India. Emerg Infect Dis 12: 1580.
-
20.
Badoni G, Gupta PK, Gupta P, Kaistha N, Mathuria YP, Pai MO, Kant R, 2023. Dengue-chikungunya infection in the tertiary care hospital of northern India: Cross-sectional latent class cluster analysis in viral infection. Heliyon 9: e14019.
-
21.
Das BK, Mohanty S, Sahoo PK, 2021. Association of leptospirosis and scrub typhus in acute encephalitis syndrome in a tertiary care hospital in Odisha, India. Trans R Soc Trop Med Hyg 115: 1088–1090.
-
22.
Diagnostic ELISA for detection of IgM antibodies against Dengue virus. Available at: https://main.icmr.nic.in/sites/default/files/Technology%20for%20Collaboration/NIV_DEN_kit.pdf. Accessed 3 October 2024.
-
23.
Diagnostic ELISA for detection of IgM antibodies against Chikungunya virus. Available at: https://main.icmr.nic.in/sites/default/files/Technology%20for%20Collaboration/NIV_CHIK_kit.pdf. Accessed 3 October 2024.
-
24.
Chelluboina S, Robin S, Aswathyraj S, Arunkumar G, 2019. Persistence of antibody response in chikungunya. Virusdisease 30: 469–473.
-
25.
Chien Y-W, Liu Z-H, Tseng F-C, Ho T-C, Guo H-R, Ko N-Y, Ko W-C, Perng GC, 2018. Prolonged persistence of IgM against dengue virus detected by commonly used commercial assays. BMC Infect Dis 18: 1–7.
-
26.
Innis B, Nisalak A, Nimmannitya S, Kusalerdchariya S, Chongswasdi V, Suntayakorn S, Puttisri P, Hoke C, 1989. An enzyme-linked immunosorbent assay to characterize dengue infections where dengue and Japanese encephalitis co-circulate. Am J Trop Med Hyg 40: 418–427.
-
27.
Edwards T, Signor LDCC, Williams C, Donis E, Cuevas LE, Adams ER, 2016. Co-infections with chikungunya and dengue viruses, Guatemala, 2015. Emerg Infect Dis 22: 2003–2005.
-
28.
Bhardwaj A, Atam V, Sawlani K, Himanshu D, Verma R, Verma S, 2022. Thrombocytopenia as a prognostic marker in patients with acute encephalitis at a tertiary care centre in northern India. J Assoc Physicians India 70: 11–12.
-
29.
Thakur KT, Motta M, Asemota AO, Kirsch HL, Benavides DR, Schneider EB, McArthur JC, Geocadin RG, Venkatesan A, 2013. Predictors of outcome in acute encephalitis. Neurology 81: 793–800.
-
30.
Kuntal M, Swarnkar K, 2020. Clinical profile and predictor of adverse outcome in children with acute encephalitis syndrome: A cross-sectional study. J Krishna Inst Med Sci University 9: 18–26.
-
31.
Adhikari A, Gajre M, Kothari R, Chaudhari N, Sangale D, 2021. Clinical profile and outcome of children admitted with acute encephalitis syndrome. Int J Contemp Pediatrics 8: 60.
| Past two years | Past Year | Past 30 Days | |
|---|---|---|---|
| Abstract Views | 830 | 830 | 218 |
| Full Text Views | 57 | 57 | 24 |
| PDF Downloads | 50 | 50 | 20 |