{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,22]],"date-time":"2026-05-22T13:08:09Z","timestamp":1779455289138,"version":"3.53.1"},"reference-count":17,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2026,5,22]],"date-time":"2026-05-22T00:00:00Z","timestamp":1779408000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: Viral meningoencephalitis is a frequent cause of acute central nervous system infection in children, particularly in neonates and young infants. Although etiological diagnosis has improved through molecular testing, management remains largely supportive, and intravenous immunoglobulins (IVIGs) are occasionally used in clinical practice despite limited supporting evidence. Methods: We performed a single-center retrospective observational study including pediatric patients aged 0\u201310 years admitted between 2016 and 2025 with molecularly confirmed viral meningoencephalitis. Demographic, clinical, microbiological, therapeutic, and follow-up data were collected. Neurological outcomes and length of hospital stay were compared between patients treated with IVIG and those who were not. Results: Twenty-nine patients were included. Enterovirus was the most frequently identified pathogen (50.0%), followed by human herpesvirus (35.7%) and human parechovirus (14.3%). IVIG was administered to 28% of patients, all with enterovirus infection. IVIG-treated patients were significantly younger at presentation and more frequently presented with apnea (42.9% vs. 0%, p = 0.014). Most patients had a favorable neurological outcome (85.7%). Unfavorable outcomes, including neurodevelopmental delay and\/or epilepsy, occurred in a minority of cases (14.3%) and exclusively in enterovirus-infected patients. No significant association was found between IVIG administration and neurological outcome. Conclusions: In this real-world pediatric cohort, IVIG use was associated with more severe clinical features rather than improved neurological outcomes, underscoring the need for careful consideration and further investigation in this setting, particularly in the subgroup of infants with enterovirus encephalitis.<\/jats:p>","DOI":"10.3390\/jcm15114024","type":"journal-article","created":{"date-parts":[[2026,5,22]],"date-time":"2026-05-22T12:14:52Z","timestamp":1779452092000},"page":"4024","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Use of Intravenous Immunoglobulins in Pediatric Viral Meningoencephalitis: A Real-World Retrospective Observational Study"],"prefix":"10.3390","volume":"15","author":[{"given":"Ilaria","family":"Lazzareschi","sequence":"first","affiliation":[{"name":"Area Pediatrica, Dipartimento di Scienze della Vita e Sanit\u00e0 Pubblica, Universit\u00e0 Cattolica del Sacro Cuore, 00168 Roma, Italy"},{"name":"Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-8280-4095","authenticated-orcid":false,"given":"Mariachiara","family":"Mercuri","sequence":"additional","affiliation":[{"name":"Area Pediatrica, Dipartimento di Scienze della Vita e Sanit\u00e0 Pubblica, Universit\u00e0 Cattolica del Sacro Cuore, 00168 Roma, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-8322-6110","authenticated-orcid":false,"given":"Ludovica","family":"Renzelli","sequence":"additional","affiliation":[{"name":"Medicine and Surgery, Universit\u00e0 Cattolica del Sacro Cuore, 00168 Roma, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2267-8077","authenticated-orcid":false,"given":"Chiara","family":"Veredice","sequence":"additional","affiliation":[{"name":"Child Neurology and Psychiatry Unit, Department of Neuroscience, Universit\u00e0 Cattolica del Sacro Cuore, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco","family":"Piastra","sequence":"additional","affiliation":[{"name":"Paediatric Intensive Care Unit and Trauma Centre, Policlinico Gemelli IRCCS, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1160-1456","authenticated-orcid":false,"given":"Anna","family":"Camporesi","sequence":"additional","affiliation":[{"name":"Division of Pediatric Anesthesia and Intensive Care, ASST Grande Ospedale Metropolitano Milano, 20162 Milano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giulia","family":"Bersani","sequence":"additional","affiliation":[{"name":"Area Pediatrica, Dipartimento di Scienze della Vita e Sanit\u00e0 Pubblica, Universit\u00e0 Cattolica del Sacro Cuore, 00168 Roma, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cristina","family":"De Rose","sequence":"additional","affiliation":[{"name":"Area Pediatrica, Dipartimento di Scienze della Vita e Sanit\u00e0 Pubblica, Universit\u00e0 Cattolica del Sacro Cuore, 00168 Roma, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"Proli","sequence":"additional","affiliation":[{"name":"Area Pediatrica, Dipartimento di Scienze della Vita e Sanit\u00e0 Pubblica, Universit\u00e0 Cattolica del Sacro Cuore, 00168 Roma, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Martino","sequence":"additional","affiliation":[{"name":"Area Pediatrica, Dipartimento di Scienze della Vita e Sanit\u00e0 Pubblica, Universit\u00e0 Cattolica del Sacro Cuore, 00168 Roma, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"De Angelis","sequence":"additional","affiliation":[{"name":"Area Pediatrica, Dipartimento di Scienze della Vita e Sanit\u00e0 Pubblica, Universit\u00e0 Cattolica del Sacro Cuore, 00168 Roma, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rosa","family":"Morello","sequence":"additional","affiliation":[{"name":"Area Pediatrica, Dipartimento di Scienze della Vita e Sanit\u00e0 Pubblica, Universit\u00e0 Cattolica del Sacro Cuore, 00168 Roma, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Barbara","family":"Fiori","sequence":"additional","affiliation":[{"name":"Microbiology Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rosaria","family":"Santangelo","sequence":"additional","affiliation":[{"name":"Microbiology Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3128-6657","authenticated-orcid":false,"given":"Roberta","family":"Onesimo","sequence":"additional","affiliation":[{"name":"Area Pediatrica, Dipartimento di Scienze della Vita e Sanit\u00e0 Pubblica, Universit\u00e0 Cattolica del Sacro Cuore, 00168 Roma, Italy"},{"name":"Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8567-2639","authenticated-orcid":false,"given":"Danilo","family":"Buonsenso","sequence":"additional","affiliation":[{"name":"Area Pediatrica, Dipartimento di Scienze della Vita e Sanit\u00e0 Pubblica, Universit\u00e0 Cattolica del Sacro Cuore, 00168 Roma, Italy"},{"name":"Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,5,22]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"303","DOI":"10.1086\/589747","article-title":"The management of encephalitis: Clinical practice guidelines by the Infectious Diseases Society of America","volume":"47","author":"Tunkel","year":"2008","journal-title":"Clin. 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