A Study on Clinical Outcome in Children with Acute Febrile Encephalopathy Admitted in Nilratan Sircar Medical College and Hospital, Kolkata

Abstract

Introduction: Acute febrile encephalopathy (AFE) in children is a serious neurological condition characterized by fever and altered mental status, with a range of etiologies including infectious, metabolic, and autoimmune causes. Understanding the clinical outcomes in these patients is crucial for improving management strategies and prognostication.

Aims: To study various clinical features of AES, find out possible etiologies of acute encephalitis syndrome and to determine outcome and effect of different prognostic markers in outcome of acute encephalitis syndrome at the time of end of hospital stay

Materials and methods: This is a Prospective Observational Study, it’s conducted from one and half year (1st March 2021 to 31st August 2022). All the cases of fever with altered sensorium from >4 hour but <2 weeks, aged 1 months to 12 years admitted in Paediatric Medicine ward of NRS Medical College & Hospital. 95 patients were including in this study.

Result: A positive JE IgM serology was found in 5 (5.26%). One patient (1.05%) had a positive MPDA. A CSF study revealed pleocytosis in 92 cases (96.44%) and polymorphic predominance in 81 cases (85.26%). CSF protein levels ranged from 40–100 mg/dl in 24 cases (25.66%) and above 100 mg/dl in 71 instances (74.74%). In 23(24.21%) and 72(75.79%) cases, the CSF sugar level was less than 40 mg/dl. Five (5.26%) of the CSF samples tested positive for JE IgM.

Conclusion: The clinical outcomes in children with acute febrile encephalopathy at Nil Ratan Sircar Medical College and Hospital reflect a significant risk of severe neurological sequelae and mortality. Early diagnosis, prompt treatment, and targeted management based on etiology are critical for improving outcomes. Future studies should focus on prospective data collection and explore targeted interventions to enhance recovery and reduce long-term effects.