Effect of High-Dose Dexamethasone on the Outcome of Acute Encephalitis Due to Japanese Encephalitis Virus

Charles H. Hoke, David W. Vaughn, Ananda Nisalak, Pensri Intralawan, Sriwanna Poolsuppasit, Viroj Jongsawas, Usa Titsyakorn, Richard T. Johnson

Research output: Contribution to journalArticlepeer-review

Abstract

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.

Original languageEnglish (US)
Pages (from-to)631-637
Number of pages7
JournalJournal of Infectious Diseases
Volume165
Issue number4
DOIs
StatePublished - Apr 1 1992
Externally publishedYes

ASJC Scopus subject areas

  • Immunology and Allergy
  • Infectious Diseases

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