Acute Infectious Encephalitis and Myelitis in Guadeloupe by New Generation Sequencing Acute Infectious Encephalitis and Myelitis in Guadeloupe by New Generation Sequencing
: Encephalitis or myelitis is defined as the inflammatory or infectious involvement of the cerebral parenchyma or spinal cord. When an infectious origin is suspected, the germ is not always identified. Next-generation sequencing could be used to correct an etiological diagnosis of these severe conditions in Guadeloupe. The rate of cases for which the infectious agent is not identified encourages continued diagnostic efforts, with the objective of identifying new pathogens or emerging pathogens, some of which may be more specific in the tropics.
• We selected the following eligibility criteria for patients with acute encephalitis:
‣ Patient of at least 28 days of life
⁃ With acute onset of symptoms for more than 24 hours
⁃ A major criterion among the following:
• a disorder of consciousness or alertness
• memory disorder
• lethargy
• modification of personal or behavioral disorder, irritability
• confusion, disorientation in time or space
• \- At least two of the following minor criteria:
• temperature above 38 ° C
• new onset focal neurological deficit
• epileptic crisis
• biological abnormality of CSF (≥ 5 Leukocytes / mm3, protein ≥ 0.40 g / L)
• partial or general epileptic seizure (s) not attributable to pre-existing epileptic disease and / or a recent focal neurological symptom
• brain imaging suggestive of encephalitis, with EEG abnormalities suggestive of encephalitis
‣ And absence of alternative diagnosis (intoxication, metabolic encephalopathy)
⁃ Persons affiliated or benefiting from a social security scheme;
⁃ Having given free, informed, written and signed consent by the patient or his legal representative (no later than the day of inclusion and prior to any review required by the research);
• Eligibility criteria for Acute Transverse Myelitis Patients:
‣ Patient of at least 28 days of life
⁃ Acute onset of symptoms for more than 24 hours
⁃ Medullary focal abnormality, responsible for motor, sensory or autonomic symptoms
⁃ contrast enhancement on bone marrow MRI and / or abnormal CSF (≥ 5GB / mm3, protein uptake ≥ 0.40 g / L)
⁃ Evolution between nadir and maximum symptoms, less than 4 weeks
⁃ Persons affiliated or benefiting from a social security scheme;
⁃ Having given free, informed, written and signed consent by the patient or his legal representative (no later than the day of inclusion and prior to any review required by the research);