METHODS: A retrospective analysis of the data of children who were diagnosed with RSV-related encephalopathy and admitted to the paediatric intensive care unit (PICU) of Beijing Children\'s Hospital between November 2016 and November 2023 was performed.
RESULTS: Four hundred and sixty-four children with RSV infection were treated in the PICU, and eight of these patients (1.7%) were diagnosed with RSV-related encephalopathy. The mean age of the patients was 24.89 (5.92 ∼ 36.86) months. Two patients had underlying diseases. The time from the onset of illness to impaired consciousness was 3 (1.88-3.75) days. Five patients had convulsions, and three patients had an epileptic status. The serum procalcitonin (PCT) level was 1.63 (0.24, 39.85) ng/ml for the eight patients, and the cerebrospinal fluid (CSF) protein level was 232 (163 ∼ 848) g/L. Among the 8 patients, four patients underwent electroencephalogram (EEG) monitoring or examination. One patient showed continuous low-voltage, nonresponsive activity, and another patient displayed persistent slow waves, the remaining two patients had negative results. One patient had a combination of acute necrotizing encephalopathy (ANE) and acute encephalopathy with biphasic seizures and late reduced diffusion (AESD). Additionally, one patient had ANE, and another had acute brain swelling (ABS). One patient died in the hospital, and the other seven patients were discharged with improvement. Routine follow-up was conducted for 4.58(0.5 ∼ 6.50) years, and all patients fully recovered.
CONCLUSIONS: RSV-related encephalopathy could have varying clinical manifestations, and some types, such as ANE and ABS, are dangerous and can lead to death.
方法:回顾性分析2016年11月至2023年11月北京儿童医院儿科重症监护病房(PICU)收治的RSV相关性脑病患儿资料。
结果:在PICU治疗了46例RSV感染儿童,其中8例(1.7%)被诊断为RSV相关性脑病。患者平均年龄为24.89(5.92~36.86)个月。两名患者有基础疾病。从发病到意识障碍的时间为3(1.88-3.75)天。五个病人有抽搐,和三个病人有癫痫状态。8例患者血清降钙素原(PCT)水平为1.63(0.24,39.85)ng/ml,脑脊液(CSF)蛋白水平为232(163~848)g/L。在8名患者中,4例患者接受了脑电图(EEG)监测或检查.一名患者表现出持续的低电压,无反应的活动,另一名患者表现出持续的慢波,其余2例患者结果为阴性.一名患者患有急性坏死性脑病(ANE)和急性脑病并伴有双相性癫痫发作和晚期扩散减少(AESD)。此外,一个病人有ANE,另一个患有急性脑肿胀(ABS)。一名病人在医院死亡,其余7名病人则好转出院。常规随访4.58(0.5~6.50)年,所有病人都完全康复了.
结论:RSV相关性脑病可能有不同的临床表现,和一些类型,如ANE和ABS,是危险的,会导致死亡。