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Sci Rep. 2019 Nov 6;9(1):16158. doi: 10.1038/s41598-019-52570-2.

Encephalitis and aseptic meningitis: short-term and long-term outcome, quality of life and neuropsychological functioning.

Author information

1
Department of Infectious Diseases, Oslo University Hospital Ullevål, Oslo, Norway. elpa1@ous-hf.no.
2
Institute of Clinical Medicine, University of Oslo, Oslo, Norway. elpa1@ous-hf.no.
3
Department of Infectious Diseases, Oslo University Hospital Ullevål, Oslo, Norway.
4
Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
5
Faculty of Medicine, University of Oslo, Oslo, Norway.
6
Department of Microbiology, Oslo University Hospital Ullevål, Oslo, Norway.
7
Department of Acute Medicine, Oslo University Hospital Ullevål, Oslo, Norway.
8
Bevital A/S, Bergen, Norway.
9
Research Institute of Internal Medicine, Oslo University Hospital Rikshospitalet, Oslo, Norway.
10
K.G. Jebsen - Thrombosis Research and Expertise Center (TREC), University of Tromsø, Tromsø, Norway.
11
Sørlandet Hospital, National Advisory Unit on Tick-borne Diseases, Kristiansand, Norway.
12
Section of Clinical Immunology and Infectious Diseases, Oslo University Hospital Rikshospitalet, Oslo, Norway.
13
Department of Physical Medicine and Rehabilitation, Oslo University Hospital Ullevål, Oslo, Norway.

Abstract

For those surviving encephalitis, the influence on daily life of patients and their relatives may be substantial. In contrast, the prognosis after aseptic meningitis (ASM) is considered good. In this prospective study in patients with encephalitis (n = 20) and ASM (n = 46), we show that both groups experienced reduced Health Related Quality of Life (HRQoL) at two months after discharge, and that workability was reduced in 37% of the patients with ASM. However, 12 months after discharge no neuropsychological deficits were detected in the ASM group, whereas patients with encephalitis had lower scores on tests of fine motor and psychomotor skills as well as on learning and memory. We also found that for patients with encephalitis, neopterin, as a marker of Th1 cell induced macrophage activation, and a putatively neurotoxic ratio of the kynurenine pathway (KP) measured during the acute phase was associated with lower HRQoL. Our data show that not only encephalitis, but also ASM has substantial short-term influence on HRQoL and workability. For patients with encephalitis we suggest a link between immune activation and activation of the KP during the acute phase with impaired HRQoL.

PMID:
31695095
PMCID:
PMC6834582
DOI:
10.1038/s41598-019-52570-2
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