{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,27]],"date-time":"2026-03-27T16:00:45Z","timestamp":1774627245285,"version":"3.50.1"},"reference-count":51,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2024,5,13]],"date-time":"2024-05-13T00:00:00Z","timestamp":1715558400000},"content-version":"vor","delay-in-days":12,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Medical Virology"],"published-print":{"date-parts":[[2024,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Acute encephalitis syndrome (AES) in children poses a significant public health challenge in India. This study aims to explore the utility of host inflammatory mediators and neurofilament (NfL) levels in distinguishing etiologies, assessing disease severity, and predicting outcomes in AES. We assessed 12 mediators in serum (<jats:italic>n<\/jats:italic>\u2009=\u200958) and 11 in cerebrospinal fluid (CSF) (<jats:italic>n<\/jats:italic>\u2009=\u200942) from 62 children with AES due to scrub typhus, viral etiologies, and COVID\u2010associated multisystem inflammatory syndrome (MIS\u2010C) in Southern India. Additionally, NfL levels in serum (<jats:italic>n<\/jats:italic>\u2009=\u200920) and CSF (<jats:italic>n<\/jats:italic>\u2009=\u200918) were examined. Clinical data, including Glasgow coma scale (GCS) and Liverpool outcome scores, were recorded. Examining serum and CSF markers in the three AES etiology groups revealed notable distinctions, with scrub typhus differing significantly from viral and MIS\u2010C causes. Viral causes had elevated serum CCL11 and CCL2 compared with scrub typhus, while MIS\u2010C cases showed higher HGF levels than scrub typhus. However, CSF analysis showed a distinct pattern with the scrub typhus group exhibiting elevated levels of IL\u20101RA, IL\u20101\u03b2, and TNF compared with MIS\u2010C, and lower CCL2 levels compared with the viral group. Modeling the characteristic features, we identified that age \u22653 years with serum CCL11\u2009&lt;\u2009180\u2009pg\/mL effectively distinguished scrub typhus from other AES causes. Elevated serum CCL11, HGF, and IL\u20106:IL\u201010 ratio were associated with poor outcomes (<jats:italic>p<\/jats:italic>\u2009=\u20090.038, 0.005, 0.02). Positive CSF and serum NfL correlation, and negative GCS and serum NfL correlation were observed. Median NfL levels were higher in children with abnormal admission GCS and poor outcomes. Measuring immune mediators and brain injury markers in AES provides valuable diagnostic insights, with the potential to facilitate rapid diagnosis and prognosis. The correlation between CSF and serum NfL, along with distinctive serum cytokine profiles across various etiologies, indicates the adequacy of blood samples alone for assessment and monitoring. The association of elevated levels of CCL11, HGF, and an increased IL\u20106:IL\u201010 ratio with adverse outcomes suggests promising avenues for therapeutic exploration, warranting further investigation.<\/jats:p>","DOI":"10.1002\/jmv.29666","type":"journal-article","created":{"date-parts":[[2024,5,13]],"date-time":"2024-05-13T06:19:09Z","timestamp":1715581149000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Diagnostic markers of acute encephalitis syndrome and COVID\u2010associated multisystem inflammatory syndrome in children from Southern India"],"prefix":"10.1002","volume":"96","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7658-3367","authenticated-orcid":false,"given":"Tina","family":"Damodar","sequence":"first","affiliation":[{"name":"Department of Neurovirology National Institute of Mental Health &amp; Neurosciences Bangalore India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cordelia","family":"Dunai","sequence":"additional","affiliation":[{"name":"Department of Clinical Infection, Microbiology &amp; Immunology, Institute of Infection, Veterinary and Ecological Sciences University of Liverpool Liverpool UK"},{"name":"National Institute for Health and Care Research Health Protection Research Unit in Emerging and Zoonotic Infections, Institute of Infection, Veterinary and Ecological Sciences University of Liverpool Liverpool UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Namratha","family":"Prabhu","sequence":"additional","affiliation":[{"name":"Department of Neurovirology National Institute of Mental Health &amp; Neurosciences Bangalore India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria","family":"Jose","sequence":"additional","affiliation":[{"name":"Department of Neurovirology National Institute of Mental Health &amp; Neurosciences Bangalore India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"L.","family":"Akhila","sequence":"additional","affiliation":[{"name":"Department of Neurovirology National Institute of Mental Health &amp; Neurosciences Bangalore India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Uddhava V.","family":"Kinhal","sequence":"additional","affiliation":[{"name":"Department of Pediatric Neurology Indira Gandhi Institute of Child Health Bangalore India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"K.","family":"Anusha Raj","sequence":"additional","affiliation":[{"name":"Department of Pediatric Neurology Indira Gandhi Institute of Child Health Bangalore India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Srilatha","family":"Marate","sequence":"additional","affiliation":[{"name":"Department of Neurovirology National Institute of Mental Health &amp; Neurosciences Bangalore India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A. 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