Please use this identifier to cite or link to this item: http://hdl.handle.net/2440/111117
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Type: Journal article
Title: Influenza-associated encephalitis/encephalopathy identified by the Australian Childhood Encephalitis study 2013-2015
Author: Britton, P.
Dale, R.
Blyth, C.
Macartney, K.
Crawford, N.
Marshall, H.
Clark, J.
Elliott, E.
Webster, R.
Cheng, A.
Booy, R.
Jones, C.
Citation: Pediatric Infectious Disease Journal, 2017; 36(11):1021-1026
Publisher: Wolters Kluwer Health Inc.
Issue Date: 2017
ISSN: 0891-3668
1532-0987
Statement of
Responsibility: 
Philip N. Britton, Russell C. Dale, Christopher C. Blyth, Kristine Macartney, Nigel W. Crawford, Helen Marshall, Julia E. Clark, Elizabeth J. Elliott, Richard I. Webster, Allen C. Cheng, Robert Booy and Cheryl A. Jones
Abstract: Background: Influenza-associated encephalitis/encephalopathy (IAE) is an important cause of acute encephalitis syndrome in children. IAE includes a series of clinicoradiologic syndromes or acute encephalopathy syndromes that have been infrequently reported outside East Asia. We aimed to describe cases of IAE identified by the Australian Childhood Encephalitis study. Methods: Children ≤ 14 years of age with suspected encephalitis were prospectively identified in 5 hospitals in Australia. Demographic, clinical, laboratory, imaging, and outcome at discharge data were reviewed by an expert panel and cases were categorized by using predetermined case definitions. We extracted cases associated with laboratory identification of influenza virus for this analysis; among these cases, specific IAE syndromes were identified where clinical and radiologic features were consistent with descriptions in the published literature. Results: We identified 13 cases of IAE during 3 southern hemisphere influenza seasons at 5 tertiary children’s hospitals in Australia; 8 children with specific acute encephalopathy syndromes including: acute necrotizing encephalopathy, acute encephalopathy with biphasic seizures and late diffusion restriction, mild encephalopathy with reversible splenial lesion, and hemiconvulsion-hemiplegia syndrome. Use of influenza-specific antiviral therapy and prior influenza vaccination were infrequent. In contrast, death or significant neurologic morbidity occurred in 7 of the 13 children (54%). Conclusions: The conditions comprising IAE are heterogeneous with varied clinical features, magnetic resonance imaging changes, and outcomes. Overall, outcome of IAE is poor emphasizing the need for optimized prevention, early recognition, and empiric management.
Keywords: Encephalitis; encephalopathy; influenza; child
Rights: Copyright © 2017 Wolters Kluwer Health, Inc. All rights reserved.
RMID: 0030072282
DOI: 10.1097/INF.0000000000001650
Grant ID: http://purl.org/au-research/grants/nhmrc/1074547
http://purl.org/au-research/grants/nhmrc/1111596
http://purl.org/au-research/grants/nhmrc/1068732
http://purl.org/au-research/grants/nhmrc/1084951
http://purl.org/au-research/grants/nhmrc/1001021
http://purl.org/au-research/grants/nhmrc/457084
http://purl.org/au-research/grants/nhmrc/1113851
Appears in Collections:Paediatrics publications

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