{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T16:52:09Z","timestamp":1791823929825,"version":"4.3.4"},"reference-count":14,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2020,7,15]],"date-time":"2020-07-15T00:00:00Z","timestamp":1594771200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"funder":[{"DOI":"10.13039\/100000030","name":"Centers for Disease Control and Prevention","doi-asserted-by":"publisher","award":["U50\/CCU915546-09"],"award-info":[{"award-number":["U50\/CCU915546-09"]}],"id":[{"id":"10.13039\/100000030","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,4,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Encephalitis is a severe neurological syndrome associated with significant morbidity and mortality. The California Encephalitis Project (CEP) enrolled patients for more than a decade. A subset of patients with acute and fulminant cerebral edema was noted.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>All pediatric encephalitis patients with cerebral edema referred to the CEP between 1998 and 2012 were reviewed. A case definition was developed for acute fulminant cerebral edema (AFCE) that included the CEP case definition for encephalitis and progression to diffuse cerebral edema on neuroimaging and\/or autopsy, and no other recognized etiology for cerebral edema (eg, organic, metabolic, toxin). Prodromic features, demographic and laboratory data, neuroimaging, and outcomes were compared with non-AFCE encephalitis cases.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Of 1955 pediatric cases referred to the CEP, 30 (1.5%) patients met the AFCE case definition. The median age for AFCE and non-AFCE cases was similar: 8.2 years (1\u201318 years) and 8.0 years (0.5\u201318 years), respectively. Asian-Pacific Islanders comprised a larger proportion of AFCE cases (44%) compared with non-AFCE cases (14%, P\u2005&amp;lt;\u2005.01). AFCE cases often had a prodrome of high fever, vomiting, and profound headache. Mortality among AFCE patients was significantly higher than among non-AFCE patients (80% vs 13%, P\u2005&amp;lt;\u2005.01). A confirmed etiology was identified in only 2 cases (enterovirus, human herpes virus type 6), while 10 others had evidence of a respiratory pathogen.<\/jats:p>\n                    <jats:p>Thirty pediatric patients referred to the California Encephalitis Project with a unique, and often fatal, form of encephalitis are reported. Demographic and clinical characteristics, possible etiologies and a proposed case definition for acute fulminant cerebral edema (AFCE) are described.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>AFCE is a recently recognized phenotype of encephalitis with a high mortality. AFCE may be triggered by common pediatric infections. Here, we propose a case definition.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/jpids\/piaa063","type":"journal-article","created":{"date-parts":[[2020,5,20]],"date-time":"2020-05-20T15:19:43Z","timestamp":1589987983000},"page":"289-294","source":"Crossref","is-referenced-by-count":37,"title":["Acute Fulminant Cerebral Edema: A Newly Recognized Phenotype in Children With Suspected Encephalitis"],"prefix":"10.1093","volume":"10","author":[{"given":"Preetha","family":"Krishnan","sequence":"first","affiliation":[{"name":"Pediatric Critical Care Medicine, Randall Children\u2019s Hospital, Portland, Oregon, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Orit A","family":"Glenn","sequence":"additional","affiliation":[{"name":"Department of Radiology, University of California\u2013San Francisco, San Francisco, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael C","family":"Samuel","sequence":"additional","affiliation":[{"name":"California Department of Public Health, Richmond, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heather","family":"Sheriff","sequence":"additional","affiliation":[{"name":"Viral and Rickettsial Disease Laboratory, California Department of Public Health, Richmond, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Audrey","family":"Foster-Barber","sequence":"additional","affiliation":[{"name":"Department of Neurology, Benioff Children\u2019s Hospital, University of California\u2013San Francisco, San Francisco, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James J","family":"Sejvar","sequence":"additional","affiliation":[{"name":"Division of High Consequence Pathogens and Pathology, National Center for Emerging Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arup","family":"Roy-Burman","sequence":"additional","affiliation":[{"name":"Univeristy of California\u2013San Francisco, San Francisco, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Debra A","family":"Wadford","sequence":"additional","affiliation":[{"name":"Viral and Rickettsial Disease Laboratory, California Department of Public Health, Richmond, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher P","family":"Preas","sequence":"additional","affiliation":[{"name":"Viral and Rickettsial Disease Laboratory, California Department of Public Health, Richmond, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jay H","family":"Tureen","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University of California\u2013San Francisco, San Francisco, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carol A","family":"Glaser","sequence":"additional","affiliation":[{"name":"Pediatric Infectious Diseases, Kaiser Permanente, Oakland, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2020,7,15]]},"reference":[{"key":"2021040614485227400_CIT0001","doi-asserted-by":"crossref","first-page":"731","DOI":"10.1086\/367841","article-title":"In search of encephalitis etiologies: diagnostic challenges in the California encephalitis project, 1998\u20132000","volume":"36","author":"Glaser","year":"2003","journal-title":"Clin Infect Dis"},{"key":"2021040614485227400_CIT0002","doi-asserted-by":"crossref","first-page":"1565","DOI":"10.1086\/509330","article-title":"Beyond viruses: clinical profiles and etiologies associated with encephalitis","volume":"43","author":"Glaser","year":"2006","journal-title":"Clin Infect 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