Clinical features and evaluation of clinical diagnosis of viral encephalitis

Objective To understand the clinical features of different types of viral encephalitis and the quality of clinical diagnosis of viral encephalitis, and provide evidence for the prevention and control of the disease. Methods The incidence data of 10 types of viral encephalitis were collected through case survey, clinical sample detection and network epidemiological surveillance of encephalitis/meningitis in Guigang in Guangxi. The comparison of clinical features among different viral encephalitis was conducted. Results The main clinical manifestations of viral encephalitis cases included fever, seizures, listlessness, some cases were accompanied with headache, vomit, nausea, lethargy and other symptoms. In most cases the clinical sign indicators and cerebrospinal fluid (CSF) test results were normal, and the glucose and chloride indicators were normal or elevated. The clinical doctors didn’t make the type specific diagnosis for acute encephalitis/meningitis cases, up to 60.04% of the cases were diagnosed with encephalitis unspecified. The correct diagnosis rate of Japanese encephalitis (JE) was only 35.71%, the missed diagnosis rate was 78.49%. Among the encephalitis cases other than JE, only 44.77% were diagnosed as encephalitis or meningitis. Conclusion The misdiagnosis and missed diagnosis rates of JE and other viral encephalitis were high only on the basis of clinical symptoms or signs, it is necessary to strengthen the laboratory detection of common viral encephalitis.