Epidemiological Profile of Acute Viral Encephalitis in a Sample of Egyptian Children

INTRODUCTION: Acute encephalitis syndrome (AES) is a considerable public health problem.AIM: This study was designed to describe the aetiology, demographic features, clinical picture, short-term outcome and risk factors of mortality of children with viral encephalitis in Egyptian children.METHODS: PCR detection of viruses in the CSF of pediatric patients admitted to the pediatric unit or ICU Cairo University Pediatric hospital presenting with encephalitis syndrome.RESULTS: Of the 96 patients included in the study, viral etiological agents were detected in 20 cases (20.8%), while 76 patients (79.2%) had no definite viral aetiology. The most abundant virus detected was Enterovirus (EV) in fourteen (14.5%), two (2.1%) were positive for human herpes simplex virus 6 (HSV-6), one (1.0%), human herpes simplex virus1 (HSV-1), one (1.0%) Epstein Barr virus (EBV), one (1.0%), cytomegalovirus (CMV) and one (1.0%) with varicella-zoster virus (VZV). On the short term outcome, 22 (22.9) patients died, and 74 (77.1%) survived. Severity outcome among survival was vegetative in three cases (4%) severe in 9 (12.16%), moderate in 14 (18.9%), mild in 29 (39.2%) and full recovery in 19 (25.6%). Mortality risk factors for younger age, the presence of apnea, the need for mechanical ventilation and the presence of abnormal CT findings were all significantly associated with fatal outcome (p < 0.05).CONCLUSION: Enterovirus was the most common cause of encephalitis among Egyptian children. Mortality was correlated with younger age and disease severity at admission. Sequelae were high among infected children

Serum Amyloid A Level in Egyptian Children with Familial Mediterranean Fever

Background and Objectives. SAA is an acute-phase reactant detected during an FMF attack or other inflammatory conditions. High SAA levels may increase the risk of amyloidosis. The aim of the study is to measure the serum amyloid A (SAA) level in a group of Egyptian children with familial Mediterranean fever (FMF) and study its various correlates, if any. Methods. The study enrolled seventy-one children with FMF. Results. SAA level was high in 78.9% of the studied patients with a mean of 81.62±31.6 mg/L, and CRP was positive in 31% of patients. There was no significant releation between SAA level and any demographic or clinical manifestation. High SAA was more frequent in V726A allele (16.9%) followed by M694V allele (12.3%). Elevated SAA levels were more frequent in patients on low colchicine doses. Forty-five percent (45%) of patients have low adherence to colchicine therapy. Interpretation and Conclusion. High SAA levels were detected two weeks after last FMF attack in a large percentage of Egyptian FMF children. This indicates that subclinical inflammation continues during attack-free periods, and SAA could be used as a marker of it

Relevance of hypocapnia to febrile seizures in children

AbstractBackgroundFebrile seizure is the most common type of convulsion in children. However, there are scanty data on the mechanism of its development. The aim of this study was to evaluate the venous blood gas status in children with febrile seizures and to determine whether hypocapnia secondary to hyperthermia-induced hyperventilation was associated with febrile seizures in children.Patients and methodsThe study enrolled 43 individuals, twenty-two children with febrile seizures, together with 21 controls (children with febrile illness without seizures). Venous blood gases were determined in the febrile seizure group within 1h and at 24h after a seizure attack while, venous blood gases were measured once in the control group within 1h after a febrile period.ResultsThere were significant differences in mean blood pH and Pco2 between the febrile seizure and control groups (p<0.001). There was no significant difference in pH values between the children with complex febrile seizure and those with simple febrile seizure. However, children with complex febrile seizure had significantly lower Pco2 within 1h of seizure attack than those with simple febrile seizure. In addition, there was a significant correlation between duration of the seizure attack and Pco2 value within 1h of seizure.ConclusionThe results of the present study confirmed the association between febrile seizure and hypocapnia and that supported the role of hypocapnia in the development of febrile seizures