Navigation Links
Johns Hopkins researchers identify conditions most likely to kill encephalitis patients
Date:8/20/2013

People with severe encephalitis inflammation of the brain are much more likely to die if they develop severe swelling in the brain, intractable seizures or low blood platelet counts, regardless of the cause of their illness, according to new Johns Hopkins research.

The Johns Hopkins investigators say the findings suggest that if physicians are on the lookout for these potentially reversible conditions and treat them aggressively at the first sign of trouble, patients are more likely to survive.

"The factors most associated with death in these patients are things that we know how to treat," says Arun Venkatesan, M.D., Ph.D., an assistant professor of neurology at the Johns Hopkins University School of Medicine and leader of the study published in the Aug. 27 issue of the journal Neurology.

Experts consider encephalitis something of a mystery, and its origins and progress unpredictable. While encephalitis may be caused by a virus, bacteria or autoimmune disease, a precise cause remains unknown in 50 percent of cases. Symptoms range from fever, headache and confusion in some, to seizures, severe weakness or language disability in others. The most complex cases can land patients in intensive care units, on ventilators, for months. Drugs like the antiviral acyclovir are available for herpes encephalitis, which occurs in up to 15 percent of cases, but for most cases, doctors have only steroids and immunosuppressant drugs, which carry serious side effects.

"Encephalitis is really a syndrome with many potential causes, rather than a single disease, making it difficult to study," says Venkatesan, director of the Johns Hopkins Encephalitis Center.

In an effort to better predict outcomes for his patients, Venkatesan and his colleagues reviewed records of all 487 patients with acute encephalitis admitted to The Johns Hopkins Hospital and Johns Hopkins Bayview Medical Center between January 1997 and July 2011. They focused further attention on patients who spent at least 48 hours in the ICU during their hospital stays and who were over the age of 16. Of those 103 patients, 19 died. Patients who had severe swelling in the brain were 18 times more likely to die, while those with continuous seizures were eight times more likely to die. Those with low counts in blood platelets, the cells responsible for clotting, were more than six times more likely to die than those without this condition.

The findings can help physicians know which conditions should be closely monitored and when the most aggressive treatments some of which can come with serious side effects should be tried, the researchers say. For example, it may be wise to more frequently image the brains of these patients to check for increased brain swelling and the pressure buildup that accompanies it.

Venkatesan says patients with cerebral edema may do better if intracranial pressure is monitored continuously and treated aggressively. He cautioned that although his research suggests such a course, further studies are needed to determine if it leads to better outcomes for patients.

Similarly, he says research has yet to determine whether aggressively treating seizures and low platelet counts also decrease mortality.

Venkatesan and his colleagues are also developing better guidelines for diagnosing encephalitis more quickly so as to minimize brain damage. Depending on where in the brain the inflammation is, he says, the illness can mimic other diseases, making diagnosis more difficult.

Another of the study's co-authors, Romergryko G. Geocadin, M.D., an associate professor of neurology who co-directs the encephalitis center and specializes in neurocritical care, says encephalitis patients in the ICU are "the sickest of the sick," and he fears that sometimes doctors give up on the possibility of them getting better.

"This research should give families and physicians hope that, despite how bad it is, it may be reversible," he says.


'/>"/>

Contact: Stephanie Desmon
sdemon1@jhmi.edu
410-955-8665
Johns Hopkins Medicine
Source:Eurekalert

Related medicine news :

1. 29 Johns Hopkins stem cell researchers awarded funding
2. Johns Hopkins African bioethics program receives 5-year continuation grant from NIH
3. Johnson & Johnson Violated FDA Order to Halt Sales of Transvaginal Mesh
4. Johns Hopkins researchers return blood cells to stem cell state
5. Johns Hopkins team finds ICU misdiagnoses may account for as many annual deaths as breast cancer
6. Johns Hopkins Armstrong Institute receives $8.9 million patient safety grant
7. Results from study of Mead Johnsons Enfamil® Human Milk Fortifier Acidified Liquid published in Pediatrics
8. Johns Hopkins scientists pair blood test and gene sequencing to detect cancer
9. The US Drug Watchdog Now Urges Women Who Suffered A Heart Attack Or Stroke After Using Yaz Yasmin Birth Control Pills To Contact The Johnson Law Group Immediately
10. The US Drug Watchdog Now Urges Any Woman Who Used The Birth Control Pills Yaz Or Yasmin And Then Had A Heart Attack Or Stroke To Call The Johnson Law Group----ASAP
11. In US first, Johns Hopkins surgeons implant brain pacemaker for Alzheimers disease
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:10/13/2017)... ... October 13, 2017 , ... ... process to promote standards of excellence for the field of eating disorders, announces ... 22 – 25, 2018 in Orlando, Florida at the Omni Resort at ChampionsGate. ...
(Date:10/13/2017)... ... 2017 , ... Apple Rehab Shelton Lakes , which specializes in the ... facility as part of a disaster drill on October 3rd. , Apple Rehab participated ... Emergency Manager, as well as the Connecticut Long Term Care Mutual Aid Plan ...
(Date:10/13/2017)... Milford, NJ (PRWEB) , ... October 13, 2017 , ... ... weekend at scenic Alexandria Park in Milford, NJ. This free event, sponsored by ... and physical activity. The fun run is geared towards children of all ages; ...
(Date:10/13/2017)... ... October 13, 2017 , ... “The Journey: From the Mountains to the ... save lost souls in the Philippines. “The Journey: From the Mountains to the Mission ... of the Bible. She has taught all ages and currently teaches a class of ...
(Date:10/12/2017)... ... , ... Planet Fitness, one of the largest and fastest growing franchisors and ... flagship location in Covington, LA at 401 N. U.S. Highway 190, in January of ... Depot in the Holiday Square shopping center. Its location allows it to serve both ...
Breaking Medicine News(10 mins):
(Date:9/12/2017)... NEW YORK , Sept. 12, 2017   EcoVadis , ... supply chains, has published the first annual edition of its Global CSR ... than 20,400 companies evaluated by EcoVadis, based on Scorecard Ratings that analyzed ... ... & Performance Index ...
(Date:9/12/2017)... 12, 2017  ValGenesis Inc., the global leader ... pleased to announce the appointment of Dr. ... Board of Directors and Chairman of Advisory Board ... science companies to manage their entire validation lifecycle ... in this process. Furthermore, ValGenesis VLMS enables rigorous ...
(Date:9/9/2017)... 8, 2017 Dealmed Medical Supplies, ... medical equipment, supplies, drugs, vaccines, and specialty medical products ... an agreement to acquire Vantage Medical Supplies, a major ... Holtsville, New York . ... and emerging medical practices, will operate under the Dealmed ...
Breaking Medicine Technology: