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Etiology and Risk Factors for Admission to the Pediatric Intensive Care Unit in Children With Encephalitis in a Developing Country
Abstract
Objective: To describe a cohort of pediatric patients with encephalitis and their risk factors for admission to the pediatric intensive care unit (PICU). Study Design: Children (<18 years old), with encephalitis evaluated by conventional microbiology and syndromic, multiplex test in cerebrospinal fluid (CSF) between July 2017 and July 2020, were recruited from 14 hospitals that comprise the Colombian Network of Encephalitis in Pediatrics. Multivariate analyses were used to evaluate risk factors associated with the need for PICU admission. Results: Two hundred two children were included, of which 134 (66.3%) were male. The median age was 23 months (IQR 5.7–73.2). The main etiologies were bacteria (n = 55, 27%), unspecified viral encephalitis (n = 44, 22%) and enteroviruses (n = 27, 13%), with variations according to age group. Seventy-eight patients (38.6%) required management in the PICU. In multivariate analysis, factors associated with admission to the PICU were the presence of generalized seizures (OR 2.73; 95% CI: 1.82–4.11), status epilepticus (OR 3.28; 95% CI: 2.32–4.62) and low leukocyte counts in the CSF (OR 2.86; 95% CI: 1.47–5.57). Compared with enterovirus, bacterial etiology (OR 7.50; 95% CI: 1.0–56.72), herpes simplex encephalitis (OR 11.81; 95% CI: 1.44–96.64), autoimmune encephalitis (OR 22.55; 95% CI: 3.68–138.16) and other viral infections (OR 5.83; 95% CI: 1.09–31.20) increased the risk of PICU admission. Conclusions: Data from this national collaborative network of pediatric patients with encephalitis allow early identification of children at risk of needing advanced care and can guide the risk stratification of admission to the PICU.
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A national study from the Colombian Pediatric Encephalitis Network reported low CSF leukocyte counts as a risk factor for pediatric intensive care unit admission.
“A national study from the Colombian Pediatric Encephalitis Network (13) also reported low CSF leukocyte counts as a risk factor for pediatric intensive care unit admission, suggesting that even in the absence of CSF abnormalities, some infections may still require intensive management.”
From Pathogen detection in acellular cerebrospinal fluid: diagnostic insights from a pediatric cohort in Colombia (2026) · cites this paper as [13]
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Pathogen and Antibody Identification in Children with Encephalitis in Myanmar
Galardi, M. M., Sowa, G. M., Crockett, C. D., Rudock, R., Smith, A. E., Shwe, E. E., San, T., Linn, K., Aye, A. M. M., Ramachandran, P. S., et al. (2023) · Annals of Neurology · doi:10.1002/ana.26560 · Cited by 14
Patiño Patiño, J. J., Osorio-Rodríguez, E., García Toscano, Y. P., Filott Tamara, M., De-Ávila-Arias, M., Rodríguez Sanjuán, A., Villarreal-Camacho, J. L., Martínez De la Rosa, W., Bilbao Ramírez, J., Coronell-Rodríguez, W., et al. (2026) · Microbiology Spectrum · doi:10.1128/spectrum.02122-25
“A national study from the Colombian Pediatric Encephalitis Network (13) also reported low CSF leukocyte counts as a risk factor for pediatric intensive care unit admission, suggesting that even in the absence of CSF abnormalities, some infections may still require intensive management.”
Self-citation
Metadata
- Authors
- Guerrero, M. P., Romero, A. F., Luengas, M., Dávalos, D. M., Mesa-Monsalve, J. G., Vivas-Trochez, R., Camacho-Moreno, G., Trujillo-Valencia, M., Giraldo, J. P. C., Mejía, L. F., Rojas-Hernández, J. P., Vinasco, N., Racines, A. R., Meléndez, A., Beltrán, C. P., López, P., Chaucanez, Y., Patiño, J., Rodríguez, W. C., Salgado, D., Martínez, M., Restrepo, A., Márquez, K., Galvis, D., Benavidez, I., Rojas, C. A., Cantor, E., & López Medina, E.
- Affiliations
- Department of Pediatrics, Universidad del Valle, Cali, Colombia
- Hospital Universitario de Neiva (CO)
- Department of Pediatrics, Infectious Diseases Unit, Fundación Hospital Pediátrico la Misericordia, Bogotá, Colombia
- Centro de Estudios en Infectología Pediátrica, Cali, Colombia
- Universidad Cooperativa de Colombia (CO)
- Universidad Pontificia Bolivariana (CO)
- Department of Pediatrics, Fundación Clínica Infantil Club Noel, Cali, Colombia
- Universidad Libre (CO)
- Department of Pediatrics, Universidad de Antioquia, Clínica el Rosario, Clínica del Prado, Medellín, Colombia
- Department of Pediatrics, Hospital Infantil Los Ángeles, Pasto, Colombia
- Fundación Valle del Lili (CO)
- Department of Pediatrics, Hospital Infantil Napoleón Franco Pareja, Universidad de Cartagena, Cartagena, Colombia
- Universidad Nacional de Colombia (CO)
- Universidad del Valle (CO)
- Universidad Surcolombiana (CO)
- Corresponding author
- Trujillo-Valencia, Mónica
- Patiño, Jaime
- Benavidez, Iván
- Rojas, Christian A.
- ORCID
- Venue
- Pediatric Infectious Disease Journal
- Published
- 2022-07-14
- Volume
- 41
- Issue
- 10
- Pages
- 806-812
- ISSN
- 0891-3668 (ISSN-L)
- OpenAlex
- W4285083226
- Cited by
- 8
- References
- 4
- Citations by year
- 2026: 1 · 2025: 2 · 2024: 2 · 2023: 1 · 2022: 2
- FWCI
- 0.86
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The Pediatric Infectious Disease Journal (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Infectious Diseases › Infectious Encephalopathies and Encephalitis
- Life Sciences › Immunology and Microbiology › Microbiology › Bacterial Infections and Vaccines
- Health Sciences › Medicine › Infectious Diseases › Viral Infections and Immunology Research
- Keywords
- pediatric encephalitis, pediatric intensive care unit admission, risk factors, etiology, bacterial encephalitis, herpes simplex encephalitis, autoimmune encephalitis, generalized seizures, status epilepticus, cerebrospinal fluid leukocyte count, viral encephalitis, enterovirus, risk stratification, developing countries, Colombia
- MeSH terms
- Adolescent, Child, Child, Preschool, Developing Countries, Encephalitis, Female, Humans, Infant, Male, Retrospective Studies, Risk Factors, Intensive Care Units, Pediatric
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