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Volume 25, Number 5—May 2019

Management of Central Nervous System Infections, Vientiane, Laos, 2003–2011

Audrey Dubot-PérèsComments to Author , Mayfong Mayxay, Rattanaphone Phetsouvanh1, Sue J. Lee, Sayaphet Rattanavong, Manivanh Vongsouvath, Viengmon Davong, Vilada Chansamouth, Koukeo Phommasone, Catrin Moore, Sabine Dittrich, Olay Lattana, Joy Sirisouk, Phonelavanh Phoumin, Phonepasith Panyanivong, Amphonesavanh Sengduangphachanh, Bountoy Sibounheuang, Anisone Chanthongthip, Manivone Simmalavong, Davanh Sengdatka, Amphaivanh Seubsanith, Valy Keoluangkot, Prasith Phimmasone, Kongkham Sisout, Khamsai Detleuxay, Khonesavanh Luangxay, Inpanh Phouangsouvanh, Scott B. Craig, Suhella M. Tulsiani, Mary-Anne Burns, David A.B. Dance, Stuart D. Blacksell, Xavier de Lamballerie, and Paul N. Newton
Author affiliations: Lao-Oxford-Mahosot Hospital-Wellcome Trust Research Unit, Mahosot Hospital, Vientiane, Laos (A. Dubot-Pérès, M. Mayxay, R. Phetsouvanh, S. Rattanavong, M. Vongsouvath, V. Davong, V. Chansamouth, K. Phommasone, C. Moore, S. Dittrich, O. Lattana, J. Sirisouk, P. Phoumin, P. Panyanivong, A. Sengduangphachanh, B. Sibounheuang, A. Chanthongthip, M. Simmalavong, D. Sengdatka, A. Seubsanith, D.A.B. Dance, P.N. Newton); University of Oxford Nuffield Department of Clinical Medicine Center for Tropical Medicine and Global Health, Oxford, UK (A. Dubot-Pérès, S.J. Lee, C. Moore, S. Dittrich, D.A.B. Dance, S.D. Blacksell, P.N. Newton); Unité des Virus Émergents (UVE: Aix-Marseille Univ-IRD 190-INSERM 1207-IHU Méditerranée Infection), Marseille, France (A. Dubot-Pérès, X. de Lamballerie); University of Health Sciences Institute of Research and Education Development, Vientiane (M. Mayxay); Mahidol University Faculty of Tropical Medicine Mahidol– Oxford Tropical Medicine Research Unit, Bangkok, Thailand (S.J. Lee, S.D. Blacksell); Mahosot Hospital, Vientiane (V. Keoluangkot, P. Phimmasone, K. Sisout, K. Detleuxay, K. Luangxay, I. Phouangsouvanh); Queensland Health Forensic and Scientific Service World Health Organization Collaborating Centre for Reference and Research on Leptospirosis, Brisbane, Queensland, Australia (S.B. Craig, S.M. Tulsiani, M.-A. Burns); London School of Hygiene and Tropical Medicine Faculty of Infectious and Tropical Diseases, London, UK (D.A.B. Dance, P.N. Newton)

Main Article

Table 1

Classifications of febrile patients with clinical central nervous system infection (n = 771), Laos, January 2003–August 2011*

Clinical sign
No. (%) patients
Additional classification, %
Stiff neck GCS score <15, seizure, or both
Stiff neck + GCS score 15 + no seizure
Stiff neck GCS score <15 Seizure WHO classification, %†
All Stiff neck No stiff neck
+ 191 (24.8) 96.2 83.5 24.8
+ + 244 (31.6) 75.2 71.5 75.2 58.8
+ + + 171 (22.2)
+ + 38 (4.9)
+ + 57 (7.4) 16.5
+ 41 (5.3)
+ 29 (3.8)

*Each line of the table corresponds to a given combination of criteria presented on the left side of the table. Each combination is then assigned (shaded cell) to >1 classifications (WHO and additional classifications) as defined in the Methods section. Green-shaded cells are the additional classifications used throughout our study. E, encephalitis; GCS, Glasgow Coma Scale; ME, meningoencephalitis; MEN, meningitis; WHO, World Health Organization; +, clinical sign present.
†Definitions of WHO classification provided in Figure 1.

Main Article


Page created: April 17, 2019
Page updated: April 17, 2019
Page reviewed: April 17, 2019
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