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Title: Management of central nervous system infections, Vientiane, Laos, 2003–2011
Authors: Audrey Dubot-Pérès
Mayfong Mayxay
Rattanaphone Phetsouvanh
Sue J. Lee
Sayaphet Rattanavong
Manivanh Vongsouvath
Viengmon Davong
Vilada Chansamouth
Koukeo Phommasone
Catrin Moore
Sabine Dittrich
Olay Lattana
Joy Sirisouk
Phonelavanh Phoumin
Phonepasith Panyanivong
Amphonesavanh Sengduangphachanh
Bountoy Sibounheuang
Anisone Chanthongthip
Manivone Simmalavong
Davanh Sengdatka
Amphaivanh Seubsanith
Valy Keoluangkot
Prasith Phimmasone
Kongkham Sisout
Khamsai Detleuxay
Khonesavanh Luangxay
Inpanh Phouangsouvanh
Scott B. Craig
Suhella M. Tulsiani
Mary Anne Burns
David A.B. Dance
Stuart D. Blacksell
Xavier de Lamballerie
Paul N. Newton
Aix Marseille Université
London School of Hygiene & Tropical Medicine
University of Oxford
Mahidol University
Queensland Health
Institute of Research and Education Development
Mahosot Hospital
Keywords: Medicine
Issue Date: 1-May-2019
Citation: Emerging Infectious Diseases. Vol.25, No.5 (2019), 898-910
Abstract: © 2019, Centers for Disease Control and Prevention (CDC). All Rights Reserved. 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.
ISSN: 10806059
Appears in Collections:Scopus 2019

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