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Varicella Zoster Virus encephalitis in Denmark from 2015 to 2019- A nationwide prospective cohort study

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Harvard

Herlin, LK, Hansen, KS, Bodilsen, J, Larsen, L, Brandt, C, Andersen, CØ, Hansen, BR, Rudolf Lüttichau, H, Helweg-Larsen, J, Wiese, L, Storgaard, M, Nielsen, H, Mogensen, TH & and the DASGIB study group 2021, 'Varicella Zoster Virus encephalitis in Denmark from 2015 to 2019- A nationwide prospective cohort study', Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, bind 72, nr. 7, s. 1192-1199. https://doi.org/10.1093/cid/ciaa185

APA

Herlin, L. K., Hansen, K. S., Bodilsen, J., Larsen, L., Brandt, C., Andersen, C. Ø., Hansen, B. R., Rudolf Lüttichau, H., Helweg-Larsen, J., Wiese, L., Storgaard, M., Nielsen, H., Mogensen, T. H., & and the DASGIB study group (2021). Varicella Zoster Virus encephalitis in Denmark from 2015 to 2019- A nationwide prospective cohort study. Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 72(7), 1192-1199. https://doi.org/10.1093/cid/ciaa185

CBE

Herlin LK, Hansen KS, Bodilsen J, Larsen L, Brandt C, Andersen CØ, Hansen BR, Rudolf Lüttichau H, Helweg-Larsen J, Wiese L, Storgaard M, Nielsen H, Mogensen TH, and the DASGIB study group. 2021. Varicella Zoster Virus encephalitis in Denmark from 2015 to 2019- A nationwide prospective cohort study. Clinical infectious diseases : an official publication of the Infectious Diseases Society of America. 72(7):1192-1199. https://doi.org/10.1093/cid/ciaa185

MLA

Vancouver

Author

Herlin, Laura Krogh ; Hansen, Kristoffer Skaalum ; Bodilsen, Jacob ; Larsen, Lykke ; Brandt, Christian ; Andersen, Christian Østergaard ; Hansen, Birgitte Rønde ; Rudolf Lüttichau, Hans ; Helweg-Larsen, Jannik ; Wiese, Lothar ; Storgaard, Merete ; Nielsen, Henrik ; Mogensen, Trine H ; and the DASGIB study group. / Varicella Zoster Virus encephalitis in Denmark from 2015 to 2019- A nationwide prospective cohort study. I: Clinical infectious diseases : an official publication of the Infectious Diseases Society of America. 2021 ; Bind 72, Nr. 7. s. 1192-1199.

Bibtex

@article{21a7c21fe6224ce0bc15c24321e329d1,
title = "Varicella Zoster Virus encephalitis in Denmark from 2015 to 2019- A nationwide prospective cohort study",
abstract = "BACKGROUND: Knowledge of the epidemiology and clinical characteristics of varicella zoster virus (VZV) encephalitis remains limited.METHODS: Nationwide prospective cohort study of adults treated for microbiologically confirmed VZV encephalitis at Danish departments of infectious diseases from 2015 to 2019. Modified Poisson regression analysis was used to compute adjusted relative risks (RRs) of unfavorable outcome.RESULTS: We identified 92 adults (49% female) with VZV encephalitis, yielding an incidence of 5.3/1 000 000 per year (95% CI, 4.2-6.6). Median age was 75 years (IQR, 67-83) and immunocompromising conditions were frequent (39%). Predominant symptoms were confusion (76%), headache (56%), nausea (45%), gait disturbance (42%), and personality changes (41%). Cranial imaging showed cerebral vasculitis (including infarction and hemorrhage) in 14 (16%) patients and encephalitic abnormalities in 11 (13%) with predilection for the brainstem and deep brain structures. Intravenous acyclovir treatment was initiated a median (IQR) of 13.4 hours (5.2-46.3) since admission, while cranial imaging and lumbar puncture were performed after 6.3 hours (2.5-31.0) and 18.5 hours (4.9-42.0). In-hospital, 1-month, and 3-month mortalities were 4%, 9%, and 11%, respectively. Unfavorable outcome (Glasgow Outcome Score of 1-4) was found in 69% at discharge, with age (adjusted RR [aRR], 1.02; 95% CI, 1.01-1.03), vasculitis (aRR, 1.38; 95% CI, 1.02-1.86), and Glasgow Coma Scale (GCS) <15 (aRR, 1.32; 95% CI, 1.01-1.73) identified as independent risk factors.CONCLUSIONS: VZV encephalitis occurs primarily in elderly or immunocompromised patients with a higher incidence than previously estimated. The diagnosis is often delayed; risk factors for unfavorable outcome are age, cerebral vasculitis, and GCS <15.",
keywords = "Acyclovir/therapeutic use, Adult, Aged, Denmark/epidemiology, Encephalitis, Varicella Zoster/drug therapy, Female, Herpes Zoster/drug therapy, Herpesvirus 3, Human, Humans, Male, Prospective Studies",
author = "Herlin, {Laura Krogh} and Hansen, {Kristoffer Skaalum} and Jacob Bodilsen and Lykke Larsen and Christian Brandt and Andersen, {Christian {\O}stergaard} and Hansen, {Birgitte R{\o}nde} and {Rudolf L{\"u}ttichau}, Hans and Jannik Helweg-Larsen and Lothar Wiese and Merete Storgaard and Henrik Nielsen and Mogensen, {Trine H} and {and the DASGIB study group}",
note = "Publisher Copyright: {\textcopyright} The Author(s) 2020. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com. Copyright: This record is sourced from MEDLINE/PubMed, a database of the U.S. National Library of Medicine",
year = "2021",
month = apr,
day = "1",
doi = "10.1093/cid/ciaa185",
language = "English",
volume = "72",
pages = "1192--1199",
journal = "Clinical Infectious Diseases",
issn = "1058-4838",
publisher = "University of Chicago Press",
number = "7",

}

RIS

TY - JOUR

T1 - Varicella Zoster Virus encephalitis in Denmark from 2015 to 2019- A nationwide prospective cohort study

AU - Herlin, Laura Krogh

AU - Hansen, Kristoffer Skaalum

AU - Bodilsen, Jacob

AU - Larsen, Lykke

AU - Brandt, Christian

AU - Andersen, Christian Østergaard

AU - Hansen, Birgitte Rønde

AU - Rudolf Lüttichau, Hans

AU - Helweg-Larsen, Jannik

AU - Wiese, Lothar

AU - Storgaard, Merete

AU - Nielsen, Henrik

AU - Mogensen, Trine H

AU - and the DASGIB study group

N1 - Publisher Copyright: © The Author(s) 2020. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com. Copyright: This record is sourced from MEDLINE/PubMed, a database of the U.S. National Library of Medicine

PY - 2021/4/1

Y1 - 2021/4/1

N2 - BACKGROUND: Knowledge of the epidemiology and clinical characteristics of varicella zoster virus (VZV) encephalitis remains limited.METHODS: Nationwide prospective cohort study of adults treated for microbiologically confirmed VZV encephalitis at Danish departments of infectious diseases from 2015 to 2019. Modified Poisson regression analysis was used to compute adjusted relative risks (RRs) of unfavorable outcome.RESULTS: We identified 92 adults (49% female) with VZV encephalitis, yielding an incidence of 5.3/1 000 000 per year (95% CI, 4.2-6.6). Median age was 75 years (IQR, 67-83) and immunocompromising conditions were frequent (39%). Predominant symptoms were confusion (76%), headache (56%), nausea (45%), gait disturbance (42%), and personality changes (41%). Cranial imaging showed cerebral vasculitis (including infarction and hemorrhage) in 14 (16%) patients and encephalitic abnormalities in 11 (13%) with predilection for the brainstem and deep brain structures. Intravenous acyclovir treatment was initiated a median (IQR) of 13.4 hours (5.2-46.3) since admission, while cranial imaging and lumbar puncture were performed after 6.3 hours (2.5-31.0) and 18.5 hours (4.9-42.0). In-hospital, 1-month, and 3-month mortalities were 4%, 9%, and 11%, respectively. Unfavorable outcome (Glasgow Outcome Score of 1-4) was found in 69% at discharge, with age (adjusted RR [aRR], 1.02; 95% CI, 1.01-1.03), vasculitis (aRR, 1.38; 95% CI, 1.02-1.86), and Glasgow Coma Scale (GCS) <15 (aRR, 1.32; 95% CI, 1.01-1.73) identified as independent risk factors.CONCLUSIONS: VZV encephalitis occurs primarily in elderly or immunocompromised patients with a higher incidence than previously estimated. The diagnosis is often delayed; risk factors for unfavorable outcome are age, cerebral vasculitis, and GCS <15.

AB - BACKGROUND: Knowledge of the epidemiology and clinical characteristics of varicella zoster virus (VZV) encephalitis remains limited.METHODS: Nationwide prospective cohort study of adults treated for microbiologically confirmed VZV encephalitis at Danish departments of infectious diseases from 2015 to 2019. Modified Poisson regression analysis was used to compute adjusted relative risks (RRs) of unfavorable outcome.RESULTS: We identified 92 adults (49% female) with VZV encephalitis, yielding an incidence of 5.3/1 000 000 per year (95% CI, 4.2-6.6). Median age was 75 years (IQR, 67-83) and immunocompromising conditions were frequent (39%). Predominant symptoms were confusion (76%), headache (56%), nausea (45%), gait disturbance (42%), and personality changes (41%). Cranial imaging showed cerebral vasculitis (including infarction and hemorrhage) in 14 (16%) patients and encephalitic abnormalities in 11 (13%) with predilection for the brainstem and deep brain structures. Intravenous acyclovir treatment was initiated a median (IQR) of 13.4 hours (5.2-46.3) since admission, while cranial imaging and lumbar puncture were performed after 6.3 hours (2.5-31.0) and 18.5 hours (4.9-42.0). In-hospital, 1-month, and 3-month mortalities were 4%, 9%, and 11%, respectively. Unfavorable outcome (Glasgow Outcome Score of 1-4) was found in 69% at discharge, with age (adjusted RR [aRR], 1.02; 95% CI, 1.01-1.03), vasculitis (aRR, 1.38; 95% CI, 1.02-1.86), and Glasgow Coma Scale (GCS) <15 (aRR, 1.32; 95% CI, 1.01-1.73) identified as independent risk factors.CONCLUSIONS: VZV encephalitis occurs primarily in elderly or immunocompromised patients with a higher incidence than previously estimated. The diagnosis is often delayed; risk factors for unfavorable outcome are age, cerebral vasculitis, and GCS <15.

KW - Acyclovir/therapeutic use

KW - Adult

KW - Aged

KW - Denmark/epidemiology

KW - Encephalitis, Varicella Zoster/drug therapy

KW - Female

KW - Herpes Zoster/drug therapy

KW - Herpesvirus 3, Human

KW - Humans

KW - Male

KW - Prospective Studies

UR - http://www.scopus.com/inward/record.url?scp=85098884493&partnerID=8YFLogxK

U2 - 10.1093/cid/ciaa185

DO - 10.1093/cid/ciaa185

M3 - Journal article

C2 - 32103249

VL - 72

SP - 1192

EP - 1199

JO - Clinical Infectious Diseases

JF - Clinical Infectious Diseases

SN - 1058-4838

IS - 7

ER -

ID: 59544930