Clinical profile and outcome of patients with meningoencephalitis in a tertiary care hospital

Background: Encephalitis is an important cause of morbidity, mortality, and permanent neurologic sequelae globally. Causes are diverse and include viral and non-viral infections. In the emergency setting differentiating the bacterial from other causes such as viral, fungal, tubercular, toxic or autoimmune causes is extremely difficult. Although plenty of literature is available on meningitis, the clinic-etiological profile and outcome with meningoencephalitis remains not that well studied, except for in paediatric population. Methods: The present prospective observational study included 75 patients who presented with acute encephalitis syndrome in tertiary care hospital, Bengaluru. All patients were subjected to complete clinical evaluation and appropriate investigations to study the etiology, clinical profile and outcome in them. Results: Among 75 patients, majority of them were <60 years constituting about 73.2%, mean age being 49.14 years with female preponderance. 30 (40%) patients had viral meningoencephalitis where aetiology was confirmed in 15 patients, remaining were presumed to be of viral aetiology. 12 (16%) had tubercular meningitis and 8 (10.6%) had bacterial meningitis followed by cryptococcal meningitis 7 (9.3%). In about 18 (24%) patients, aetiology was not identified and were treated based on syndromic approach. The most common presentation was fever and altered sensorium. Thrombocytopenia was common among viral and bacterial aetiologies and those in unspecified etiological group. Mortality was highest among cryptococcal meningitis (71.4%) followed by tubercular (66.7%) and bacterial meningitis (62.5%). Conclusions: A large number of number of cases where aetiology cannot be identified maybe benefited by a syndromic approach and better diagnostic modalities