Management of Central Nervous System Infections, Vientiane, Laos, 2003-2011.

Authors:
Mayfong Mayxay
Mayfong Mayxay
Lao-Oxford-Mahosot Hospital-Wellcome Trust Research Unit (LOMWRU)
Vientiane | Laos
Rattanaphone Phetsouvanh
Rattanaphone Phetsouvanh
Lao-Oxford-Mahosot Hospital-Wellcome Trust Research Unit
Vientiane | Laos
Sue J Lee
Sue J Lee
Mahidol University
Thailand
Sayaphet Rattanavong
Sayaphet Rattanavong
Mahosot Hospital
Manivanh Vongsouvath
Manivanh Vongsouvath
Lao-Oxford-Mahosot Hospital-Wellcome Trust Research Unit (LOMWRU)
Vientiane | Laos
Viengmon Davong
Viengmon Davong
Lao-Oxford-Mahosot Hospital-Wellcome Trust Research Unit
Vilada Chansamouth
Vilada Chansamouth
Lao-Oxford-Mahosot Hospital-Wellcome Trust Research Unit (LOMWRU)
Vientiane | Laos

Emerg Infect Dis 2019 May;25(5):898-910

During 2003-2011, we recruited 1,065 patients of all ages admitted to Mahosot Hospital (Vientiane, Laos) with suspected central nervous system (CNS) infection. Etiologies were laboratory confirmed for 42.3% of patients, who mostly had infections with emerging pathogens: viruses in 16.2% (mainly Japanese encephalitis virus [8.8%]); bacteria in 16.4% (including Orientia tsutsugamushi [2.9%], Leptospira spp. [2.3%], and Rickettsia spp. [2.3%]); and Cryptococcus spp. fungi in 6.6%. We observed no significant differences in distribution of clinical encephalitis and meningitis by bacterial or viral etiology. However, patients with bacterial CNS infection were more likely to have a history of diabetes than others. Death (26.3%) was associated with low Glasgow Coma Scale score, and the mortality rate was higher for patients with bacterial than viral infections. No clinical or laboratory variables could guide antibiotic selection. We conclude that high-dependency units and first-line treatment with ceftriaxone and doxycycline for suspected CNS infections could improve patient survival in Laos.

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Source
http://wwwnc.cdc.gov/eid/article/25/5/18-0914_article.htm
Publisher Site
http://dx.doi.org/10.3201/eid2505.180914DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6478220PMC
May 2019
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6.751 Impact Factor

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