Objective: This study aimed to determine the clinical profile and outcome of pediatric patients with acute viral encephalitis syndrome admitted at a single tertiary government hospital. Methods: All pediatric patients admitted at the Philippine General Hospital from January 2011 to December 2014 and discharged with a final diagnosis of acute viral encephalitis were included. After demographic data, clinical manifestations, and laboratory findings were collected, the outcome was determined using the Modified Rankin Scale for children. The data were summarized using descriptive statistics. The median test was used to compare the outcomes while the chi-square test was used to analyze the comparison between study groups. Results: Sixty-four patients diagnosed with acute viral encephalitis syndrome were included in the study. The highest number of cases was reported in ages 1- 4 years (32.81%) and among the male population (68.75%). The most common symptoms were seizure (46.87%), abnormal behavior (21.88%), and altered sensorium (20.31%). Forty-four patients had CSF viral studies done, and among them, the 11 (25%) were positive for Japanese encephalitis. The modified Rankin scale showed that 41 (64.08 %) subjects showed good outcomes, while 23 (35.23%) exhibited poor outcomes. There was no significant difference in the modified Rankin scale for Japanese encephalitis compared to the other etiologic agents of acute viral encephalitis (p value= 0.717). Conclusion In patients with acute viral encephalitis, the most common symptoms were seizures, abnormal behavior, and altered sensorium. Majority of the subjects did not show any significant symptoms and disability. No difference was seen in the clinical outcome of patients infected with Japanese encephalitis compared to other etiologic agents, but these results need to be verified by larger studies.<
Acute Febrile Encephalopathy ; Encephalitis, Japanese

BACKGROUND: Granulomatous amebic encephalitis is a rare condition. Only less than 200 cases have been reported worldwide, and only three survivors have been reported to date. Two types of free living ameba are known to cause granulomatous amebic encephalitis, namely Acanthamoeba spp. and Balamuthia mandrillaris.OBJECTIVES: We report the first documented case of granulomatous amebic encephalitis in our institution, and probably in the Philippines. Based on review of previous reports internationally, this may be the youngest patient reported to contract the fatal disease.CASE SUMMARY: We present a case of an 8-month old female infant who initially presented with acute blindness. Cranial ultrasonography, computed tomography and magnetic resonance imaging all showed multiple calcified intracranial lesions with progressive malacic changes. In the course of her confinement, the patient rapidly developed seizures, remittent fever and severe neurological deficits. The patient was unresponsive to anti-koch's therapy, Amphotericin B, Ceftazidime, Amikacin and Ciprofloxacin. Unfortunately, the patient expired on the 39th hospital day. At post mortem autopsy of the brain, hematoxylin and eosin stained sections and periodic acid Schiff stain showed diffuse and chronic necrotizing inflammation with numerous amebic trophozoites surrounding the perivascular area. This confirmed the diagnosis of granulomatous amebic encephalitis. Morphology of the organisms was further confirmed by electron microscopy. However, PCR for Balamuthia DNAwas negative.SIGNIFICANCE: This is the first ever documented case of granulomatous amebic encephalitis in our institution, and also probably the first case reported in our country. The differential diagnosis of amebic encephalitis should be considered among patients with CNS infections who are refractory to treatment, even if the patient has no identified risk factors, since this could affect immunocompetent children.
Encephalitis ; Central Nervous System Infections ; Central Nervous System Diseases