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

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

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