Author/Editor		Erdem, Hakan; Cag, Yasemin; Ozturk-Engin, Derya; Defres, Sylviane; Kaya, Selcuk; Larsen, Lykke; Poljak, Mario; Baršić, Bruno; Argemi, Xavier; Sørensen, Signe Maj; Jereb, Matjaž
Title		Results of a multinational study suggest the need for rapid diagnosis and early antiviral treatment at the onset of herpetic meningoencephalitis
Type		članek
Vol. and No.		Letnik 59, št. 6
Publication year		2015
Volume		str. 3084-3089
ISSN		0066-4804 - Antimicrobial agents and chemotherapy
Language		eng
Abstract		Data in the literature regarding the factors that predict unfavorable outcomes in adult herpetic meningoencephalitis (HME) cases are scarce. We conducted a multicenter study in order to provide insights into the predictors of HME outcomes, with special emphasis on the use and timing of antiviral treatment. Samples from 501 patients with molecular confirmation from cerebrospinal fluid were included from 35 referral centers in 10 countries. Four hundred thirty-eight patients were found to be eligible for the analysis. Overall, 232 (52.9%) patients experienced unfavorable outcomes, 44 died, and 188 survived, with sequelae. Age (odds ratio [OR], 1.04; 95% confidence interval [CI], 1.02 to 1.05), Glasgow Coma Scale score (OR, 0.84; 95% CI, 0.77 to 0.93), and symptomatic periods of 2 to 7 days (OR, 1.80; 95% CI, 1.16 to 2.79) and >7 days (OR, 3.75; 95% CI, 1.72 to 8.15) until the commencement of treatment predicted unfavorable outcomes. The outcome in HME patients is related to a combination of therapeutic and host factors. This study suggests that rapid diagnosis and early administration of antiviral treatment in HME patients are keys to a favorable outcome.
Keywords		herpetic meningoencephalitis rapird diagnosis early antiviral treatment multinational study