Evidence map›Paper›PMID 35099587›Full record

ArticleJournal of neurology2022

Herpetic encephalitis: which treatment for which body weight?

Marine Mulatero, Mohamed Boucekine, Olivier Felician, Salah Boussen, Gilles Kaplanski, Pascal Rossi, Philippe Parola, Andréas Stein, Philippe Brouqui, Jean Christophe Lagier and 2 more

Abstract read
PubMed Publisher
In one paragraph

Article in Journal of neurology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed, 1 pooled it
0.9field-weighted citation impact, top 27% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 1 synthesis or guideline pooled it, 6 citations in OpenAlex.

  1. Pooled it
  2. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors at 6 institutions in 2 countries.

Marine MulateroService de Médecine Interne, CHU Conception, Assistance Publique Hôpitaux de Marseille, 147 Boulevard Baille, 13385, Marseille Cedex 5, France.
Mohamed BoucekineAix-Marseille Univ, Faculté de Médecine, Secteur Timone, EA 3279: CEReSS, Centre d'Etude Et de Recherche Sur Les Services de Santé Et La Qualité de Vie, 27 Boulevard Jean Moulin, 13005, Marseille, France.
Olivier FelicianService de Neuropsychologie, CHU Timone, Assistance Publique Hôpitaux de Marseille, Pôle de Neurosciences Cliniques, Marseille, France.
Salah BoussenService d'Anesthésie-Réanimation, CHU Timone, Assistance Publique Hôpitaux de Marseille, Aix-Marseille University, Marseille, France.
Gilles KaplanskiService de Médecine Interne, CHU Conception, Assistance Publique Hôpitaux de Marseille, 147 Boulevard Baille, 13385, Marseille Cedex 5, France.
Pascal RossiService de Médecine Interne, CHU Nord, Assistance Publique Hôpitaux de Marseille, Marseille, France.
Philippe ParolaInstitut Hospitalo-Universitaire Méditerranée Infection, CHU Timone, Assistance Publique Hôpitaux de Marseille, Marseille, France.
Andréas SteinInstitut Hospitalo-Universitaire Méditerranée Infection, CHU Timone, Assistance Publique Hôpitaux de Marseille, Marseille, France.
Philippe BrouquiInstitut Hospitalo-Universitaire Méditerranée Infection, CHU Timone, Assistance Publique Hôpitaux de Marseille, Marseille, France.
Jean Christophe LagierInstitut Hospitalo-Universitaire Méditerranée Infection, CHU Timone, Assistance Publique Hôpitaux de Marseille, Marseille, France.
Marc LeoneDépartement de Réanimation, CHU Nord, Assistance Publique Hôpitaux de Marseille, Marseille, France.
Elsa KaphanService de Médecine Interne, CHU Conception, Assistance Publique Hôpitaux de Marseille, 147 Boulevard Baille, 13385, Marseille Cedex 5, France. elsa.kaphan@ap-hm.fr.ORCID http://orcid.org/0000-0002-0155-8597
Méditerranée Infection Foundation · FRHôpital de la Conception · FRAix-Marseille Université · FRAssistance Publique Hôpitaux de Marseille · FRCeres · USInserm · FR

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPrognosis of herpetic encephalitis remains severe, with a high proportion of deaths and sequelae. Its treatment is based on acyclovir, but the precise and most effective modalities of this treatment are not established. The objective of this study was to determine them.

methodsFor this, we carried out a descriptive, retrospective, monocentric study, using the current coding database at Marseille University Hospitals. Cohort was intended to be exhaustive for the disease, from January 2000 to June 2019, including patients hospitalized in intensive care and conventional hospitalization sector. Patients (n = 76) included were at least 16 years of age and had a clinical presentation, cerebral Magnetic Resonance Imaging, and/or electroencephalogram abnormalities consistent with herpetic encephalitis confirmed by a positive HSV-PCR in the CSF. Clinical data and treatment, including the doses actually administered to the patient, were compared according to patient's outcome.

resultsThe mortality rate was 12%, whereas 49% had complete recovery and 39% sequelae impeding independence. Poor outcome was statistically associated with persistence of confusion, aphasia, and impaired consciousness lasting more than 5 days, superinfection, status epilepticus, and length of stay in intensive care unit. A statistical decision tree, constructed using the Classification And Regression Tree model, to prioritize treatment management, showed two main factors that influence the outcome: the patient's weight, and the average daily acyclovir dose actually administered.

conclusionThese results suggest to modify acyclovir management in herpetic encephalitis, for low-weight patients (< 79 kg) with a minimum dosage of 2550 mg/day (850 mg/ 8 h), when possible.

Indexed as

Encephalitis, Herpes SimplexAcyclovirAntiviral AgentsBody WeightDisease ProgressionHumansRetrospective StudiesAcyclovirAntiviral AgentsAcyclovirEncephalitisHerpes simplex virusHSVPrognosis

Identifiers

PMID35099587
OpenAlexW4210709920

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.