Étude descriptive des encéphalites et myélites infectieuses aiguës en Guadeloupe du 1er janvier au 31 décembre 2015

Abstract : Introduction: encephalitis or myelitis are defined as the inflammatory or infectious involvement of the cerebral parenchyma or spinal cord. When an infectious originis suspected, the germis not always identified. In the tropics, specific pathogens can be implicated. In Guadeloupe, a region exposed to arboviruses, these infectious agents are among the causes of acute infectious attacks of the central nervous system. Material and methods: a total of 65 patients were retrospectively enrolled in an Observational study from the University Hospital of Pointe-à-Pitre over a period of 4 years (January 1, 2012 to December 31, 2015). Objectives : the main objective of this study was to determine the etiological factors of encephalitis and myelitis. The secondary objectives were to describe the clinical, paraclinical, epidemiological characteristics and the diagnosis strategy of these diseases. Results: out of 257 records of central nervous system infections from the Information Systems Medicalization Program database, we identified 63 encephalitis and 2 myelitis. Men accounted for 65% (n = 42), women for 35% (n = 23) (sex ratio H / F = 1.8). Children represented 28% of the patients (n = 18). The mortality rate was 5%. The most common etiologies were varicella-zoster infections, leptospirosis and infections due to herpes simplex virus. Two arboviruses, dengue and chikungunya, were responsible for 11% of cases over the entire study period and of 30% of cases occurred in 2014, a period of dengue and chikungunya epidemics. In 46% of cases the causative agent was not identified. The presence of the infectious agent or its genome in the cerebro-spinal fluid allowed a diagnosis of certainty in 26% of cases. Of these, 63% had a viral etiology (n = 22). Conclusion : this study allowed to identify the pathogens involved in acute infectious diseases of the central nervous system in the tropical region of Guadeloupe. Compared to studies carried out in Western countries, infectious agents such as arboviruses and leptospirosis are often implicated. Further prospective studies will be necessary in the French West Indies to improve the understanding of these severe pathologies whose consequences represent real public health issues in a short and long term perspective.
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Master Thesis
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Hugo Chaumont. Étude descriptive des encéphalites et myélites infectieuses aiguës en Guadeloupe du 1er janvier au 31 décembre 2015. Sciences du Vivant [q-bio]. 2018. ⟨dumas-01957497⟩



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