TY - JOUR
T1 - Effect of High-Dose Dexamethasone on the Outcome of Acute Encephalitis Due to Japanese Encephalitis Virus
AU - Hoke, Charles H.
AU - Vaughn, David W.
AU - Nisalak, Ananda
AU - Intralawan, Pensri
AU - Poolsuppasit, Sriwanna
AU - Jongsawas, Viroj
AU - Titsyakorn, Usa
AU - Johnson, Richard T.
PY - 1992/4/1
Y1 - 1992/4/1
N2 - Death due to Japanese encephalitis usually occurs in the first 5 days of hospitalization as a result of deepening coma with respiratory arrest. Death may result from edema-induced increases in intracranial pressure that might be reduced by the administration of steroids. Sixty-five patients presenting in Thailand to four hospitals with a diagnosis of acute Japanese encephalitis were randomized in a double-masked fashion and stratified by initial mental status into a placebo group (saline) or a treatment group (dexamethasone 0.6 mg/kg intravenously as a loading dose followed by 0.2 rug/kg every 6 h for 5 days). Fifty-five of the 65 had confirmed Japanese encephalitis as demonstrated by detection of virus or by Japanese encephalitis virus-specific IgM antibody. Important outcome measures included mortality (24%, treatment group; 27%, control group), days to alert mental status (3.9 vs. 6.2), and neurologic status 3 months after discharge (45% abnormal in each group). No statistically significant benefit of high-dose dexamethasone could be detected.
AB - Death due to Japanese encephalitis usually occurs in the first 5 days of hospitalization as a result of deepening coma with respiratory arrest. Death may result from edema-induced increases in intracranial pressure that might be reduced by the administration of steroids. Sixty-five patients presenting in Thailand to four hospitals with a diagnosis of acute Japanese encephalitis were randomized in a double-masked fashion and stratified by initial mental status into a placebo group (saline) or a treatment group (dexamethasone 0.6 mg/kg intravenously as a loading dose followed by 0.2 rug/kg every 6 h for 5 days). Fifty-five of the 65 had confirmed Japanese encephalitis as demonstrated by detection of virus or by Japanese encephalitis virus-specific IgM antibody. Important outcome measures included mortality (24%, treatment group; 27%, control group), days to alert mental status (3.9 vs. 6.2), and neurologic status 3 months after discharge (45% abnormal in each group). No statistically significant benefit of high-dose dexamethasone could be detected.
UR - http://www.scopus.com/inward/record.url?scp=0026684580&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0026684580&partnerID=8YFLogxK
U2 - 10.1093/infdis/165.4.631
DO - 10.1093/infdis/165.4.631
M3 - Article
C2 - 1313068
AN - SCOPUS:0026684580
SN - 0022-1899
VL - 165
SP - 631
EP - 637
JO - Journal of Infectious Diseases
JF - Journal of Infectious Diseases
IS - 4
ER -