Abstract Details

Title Prognostic and Clinical Significance of Hypoglycorrhachia in Adults with Encephalitis

Topic Infectious Disease

Presentation(s) P2 - Poster Session 2 (11:45 AM-12:45 PM)

Poster/Presentation
Number 13-002

Objective

The aim was to determine the clinical and prognostic significance of hypoglycorrhachia in encephalitis.

Background Encephalitis is an inflammation of the brain caused by several infectious or non-infectious etiologies (e.g., autoimmune encephalitis) that can lead to neurological complications and death. Hypoglycorrhachia (cerebrospinal fluid glucose level < 45 mg/dl) is associated with worse clinical outcomes in meningitis.

Design/Methods We conducted an IRB-approved, retrospective chart review of patients diagnosed with encephalitis from Greater Houston and Greater Baltimore regions between 2005 and 2022 based on the 2013 International Encephalitis Consortium inclusion criteria. We collected data on demographic features, presenting symptoms, imaging findings, and clinical outcomes. A bivariate analysis was used to analyze dichotomous clinical features by performing a chi-square test and utilizing Pearson Chi Square and Fisher Exact Test values. Descriptive statistics were also used, including median for continuous variables.

Results Of the 614 patients enrolled in this study (32% viral, 18% autoimmune, 50% unclear/other etiology), 17.8% had hypoglycorrhachia (n=109). Patients with hypoglycorrhachia were significantly more likely to be immunocompromised and HIV positive, as well as present with higher rates of fever, headache, neck stiffness, and leukocytosis (p<0.05). Hypoglycorrhachia was significantly less likely to present with seizures, memory deficits, and psychiatric symptoms (p<0.05). Patients with hypoglycorrhachia were statistically less likely to have encephalitis of an autoimmune etiology (4.5% vs 16.5%, p<.001). Hypoglycorrhachia was also more likely to present with abnormal CT imaging (31.5% vs 20.7%, p=.032). Patients with hypoglycorrhachia were less likely to die (p<.001) and have adverse clinical outcomes as defined by the Glasgow Outcome Scale (p=.015).

Conclusions Hypoglycorrhachia was seen more commonly in immunocompromised hosts with abnormal cranial imaging and less likely in autoimmune encephalitis. In contrast to meningitis, hypoglycorrhachia was associated with better patient outcomes.

Authors/Disclosures
Sienna Wu PRESENTER	Ms. Wu has nothing to disclose.
Rodrigo Hasbun	Rodrigo Hasbun has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Biomeriaux. The institution of Rodrigo Hasbun has received research support from Biomeriaux.
Arun Venkatesan, MD, PhD (Johns Hopkins Hospital)	Dr. Venkatesan has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Janssen Pharmaceuticals. The institution of Dr. Venkatesan has received research support from NIH. The institution of Dr. Venkatesan has received research support from U.S. DOD.
John Probasco, MD, FAAN (The Johns Hopkins Hospital)	Dr. Probasco has received personal compensation in the range of $10,000-$49,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for NEJM Clinician. The institution of Dr. Probasco has received research support from Roche/Genentech.
Laya Rao (Villas at Hermann Park)	Ms. Rao has nothing to disclose.
Paris Bean	No disclosure on file
Ralph Habis, MD (Johns Hopkins School of Medicine)	Dr. Habis has nothing to disclose.
Ashley Heck	No disclosure on file
Rajesh K. Gupta, MBBS (UTHealth)	Dr. Gupta has nothing to disclose.

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