ISSN: 2578-5044
Influenza-Associated Neurological Complications - Clinical Course and Prognostic Factors
Authors:
Pekova L1*, Parousheva P1, Tzoneva V2, Naydenov K3, Mitev M4, Petrov D5, Angelova S6 and Korsun N6
Acute influenza-associated encephalopathy/encephalitis (IAE) in children and adults is not so common but very serious and sometimes fatal neurological complication. The purpose was to show clinical and laboratorial peculiarities in this condition and to indicate some prognostic factors.
Materials and methods: In a period of three years (2014-2017) through the Clinic of Infectious diseases at the University Hospital in Stara Zagora, Bulgaria 7 patients with this neuroinfection were passed. They were aged between 3 and 42 years. Clinical, epidemiological, laboratorial and instrumental investigations were accomplished in all patients. The results were processed with statistical program SPSS for Windows, v. 14.
Results and discussion: Clinical manifestations appeared in 5 patients with an initial convulsion usually within 24-72 hours after the acute onset of the disease and quantitative changes in consciousness to coma in 3. Clinical manifestations of meningeal irritation were detected in only two patients Laboratory blood tests showed in 3 patients’ elevated levels of leucocytes and amino transferases, high urea, glucose and creatinin. The findings of cerebrospinal fluid in them indicated albumin values from 1,0 to 6,0 g/l and increased glucose from 4,5 to 21 mmol/l. All of these three patients ended up with a fatal outcome. Their pathological outcomes detected necrotizing encephalopathy. The remaining 4 patients were fully recovered except for one in which there is a 7 cranial-brain nerve paresis as a residual symptom. The diagnosis was confirmed by clinical and epidemiological data, but also by serological (ELISA) in blood investigations and virological (PCR) in nasal swabs and also in autopsy material. In all but one influenza A virus was detected. Influenza virus B strainVictoria was detected with him. All patients were treated with Oseltamivir in appropriate doses. None of them were vaccinated against influenza.
Conclusion: IAE had a well-known clinical course. Some extremely elevated laboratorial changes as amino transferases, blood sugar and urea may predict a lethal outcome. IAE was a complication which could be avoid by specific vaccine use. Influenza; Neurological Complications; Outcome
Keywords:
Influenza; Neurological Complications; Outcome
