Volume 19, Number 2—February 2013
CME ACTIVITY - Synopsis
Eastern Equine Encephalitis in Children, Massachusetts and New Hampshire,USA, 1970–2010
Michael A. Silverman, John Misasi, Sandra Smole, Henry A. Feldman, Adam B. Cohen, Sandro Santagata, Michael McManus, and Asim A. Ahmed
Table 1
Clinical features of and diagnostic studies for 15 children with eastern equine encephalitis, Massachusetts and New Hampshire, 1970–2010*
| Patient no. | Admitted to hospital | Age, y/sex | Prodome length, d | Blood leukocytes, 103 cells/μL | CSF leukocytes, cells/μL | CSF protein, mg/dL | ICP checked | Treatment | Outcome at discharge | Status at follow-up |
|---|---|---|---|---|---|---|---|---|---|---|
| 1 | 1970 Aug | 0.5/M | 2 | 28.0 | 300 | 64 | No | AEDs, mannitol | Severe disability | Stable |
| 2 | 1974 Aug | 1.2/M | 2 | No | Death | – | ||||
| 3 | 1982 Sep | 0.8/M | 1 | 17.1 | 11 | 66 | No | Vidarabine, acyclovir, AEDs, dexamethasone | Severe disability | Improved |
| 4 | 1982 Sep | 14.7/F | 2 | 17.3 | 1,004 | 80 | Yes | AEDs, mannitol | Severe disability | Improved |
| 5 | 1983 Aug | 11.2/M | 3 | 21.0 | 720 | 61 | No | Mannitol | Full recovery | – |
| 6 | 1984 Aug | 6.5/F | 0 | 21.0 | 1,384 | 46 | Yes | Acyclovir, AEDs, pentobarbitol coma, dexamethasone, mannitol | Severe disability | Improved |
| 7 | 1995 Aug | 0.5/M | 4 | 13.6 | 451 | 73 | No | Acyclovir, AEDs, IVIG, dexamethasone, cyclophosphamide | Severe disability | – |
| 8 | 2000 Sep | 4.0/F | 5 | 22.7 | 258 | 33 | No | Acylovir, AEDs | Full recovery | – |
| 9 | 2001 Aug | 3.9/F | 5 | 12.0 | 1,200 | 54 | No | Acylovir, AEDs | Mild to moderate disability | Fully recovered |
| 10 | 2004 Aug | 13.1/M | 0 | 8.4 | 860 | 84 | No | Acylovir, AEDs dexamethasone, mannitol, 3% saline | Death | – |
| 11 | 2004 Oct | 11.5/F | 8 | 16.5 | 616 | 73 | No | Acylovir | Full recovery | – |
| 12 | 2005 Aug | 5.3/F | 2 | 34.8 | 847 | 73 | No | Acylovir, AEDs, 3% saline | Death | – |
| 13 | 2006 Aug | 9.9/M | 2 | 23.0 | 1,085 | 81 | Yes | Acylovir, AEDs, pentobarbitol coma, interferon α-2b, dexamethasone, IVIG, 3% saline | Death | – |
| 14 | 2007 Aug | 13.3/M | 6 | 20.4 | 888 | 124 | No | Acylovir, AEDs, IVIG, 3% saline | Mild to moderate disability | Stable |
| 15 | 2009 Sep | 3.5/F | 5 | 17.8 | 258 | 39 | No | Acylovir, AEDs, dexamethasone | Full recovery | – |
*CSF, cerebrospinal fluid; ICP, intracranial pressure; AEDs, anti-epileptic drugs (phenobarbital, phenytoin, fosphenytoin, carbamazepine, oxcarbazepine, lorazepam, levetiracetam); –, patient died or did not return for follow-up; IVIG, intravenous immunoglobulin
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