Background: Acute encephalitis syndrome (AES) is defined as the acute-onset of fever and a change in mental status, these can include signs and symptoms such as confusion, disorientation, delirium or coma and/or new-onset of seizures. (Simple febrile seizures are not included) in a person of any age at any time of the year. AES is reported mainly from states like Assam, Bihar, Tamil Nadu, Karnataka, Uttar Pradesh attribute to major percentage of cases with over all case fatality rate of 20-25%. The objective of present work was to study the occurrence and outcome of AES cases admitted in PICU

Methods: This study was conducted in children admitted in PICU, Silchar medical college and hospital over a period of 1 year (July 2019 to June 2020).92 AES cases were admitted over this period. History, clinical features, demography, immunization status and outcome were recorded. Results of blood investigation, CSF analysis and IgM ELISA for HSV, JE, CMV, Dengue, scrub typhus were recorded and analysed.

Results: The percentage of AES in PICU was 7.47% (92/1230). Mean age of the cases was 4.3+-3.2 years. Male to female ratio was 2.06:1.The percentage of children who presented as AES and were not immunized fully was 91.3%.Most common presentation was seizure. Dysglycemia was present in 15.2% of cases. 6.5% of AES cases were JE positive. Hyponatremia (p value 0.007747) and shock (p value 0.00001) at presentation were associated with increased mortality. Mortality rate of infants were found to be higher than non infants. Behavioual disturbances were found in 20% of follow up cases.

Conclusions: 6.5% of AES cases were JE positive. Hyponatremia at presentation of AES cases are associated with increased risk of mortality, so it need priority care. Prompt identification and treatment of dysglycemia and shock are important in AES cases. General awareness and proper education amoung people about the immunization and hygienic practices  will be beneficial.

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Anupama Deka

Professor and HOD, Department of Pediatrics, Silchar Medical College, Silchar, India