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Etiological, clinical and epidemiological characteristics of acute meningitis, encephalitis and meningoencephalitis at a Brazilian Tertiary Care Hospital ,Hospital das Clinicas ,São Paulo University, Medical School


The clinical approach to meningitis and encephalitis is challenging due to a broad differential diagnosis and high potential for morbidity and mortality1,2. A significant portion of patients with meningitis (15-60%) or encephalitis (40-70%) do not have the identification of the etiologic agent involved in these situations1,2. The main barrier to the etiological diagnosis is the difficulty of access to rapid diagnostic tests. Diagnostic failures determine not only increased morbidity and mortality as a whole, but also are responsible for unnecessary treatments and potentially preventable adverse events.Neurological, cognitive, and behavioral problems caused by these infections are likely to affect millions of children and adults around the world, particularly in low- and middle-income countries3. However, particularly in these regions of the world, including Brazil, information on the etiology, morbidity and pathogenesis of central nervous system infections is scarce. It is also important to mention the importance of the presence of arboviruses dengue, chikungunya and Zika in Brazil, which has also been associated with severe neurologic outcomes.Due to the paucity of information regarding the etiological profile of these infections in Brazil, we propose to carry out the present study, which aims to contribute to the clarification of the profile of agents involved in CNS infections in our country.The definition of this etiological profile should contribute to the optimization of the therapeutic regimens currently used. Clarification regarding these infectious agents should also enable us to propose more specific interventions, such as the use of vaccines or vector control, which may also contribute to better control of these diseases in our country.In addition to the definition of the diagnostic algorithm involved in the care of these patients, we believe that our project may provide samples for future genomic characterization of new agents and possible biomarkers associated with the prognosis of these infections. (AU)

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