A Prospective Observational Study of Children with FS-Associated Hospitalization: The Implication and Outcomes of Pathogen Detection in Cerebrospinal Fluid

Figures & data

Figure 1 Flow chart of patient enrollment. ^aThirteen were found to be ineligible because they had a history of afebrile seizures, underlying neurological disease or suspected acute infection involving the central nervous system. Five were eligible but did not have sufficient CSF volume, and 12 declined consents.

Table 1 Demographics of Pediatric Patients with FS-Associated Hospitalization

Items		FS and FS Plus (n=99)	Encephalitis/Meningitis (n=11)	Epilepsy (n=9)	P value
Demographics	Male	62%	73%	33%	0.172
	Age (years)	2.6 (1, 4)	2 (1.6, 4)	7 (1.5, 9)	0.174
Febrile seizures	FS history	40%	36%	56%	0.638
	FS family history	36%	18%	22%	0.362
	Recurrent FS	48%	64%	56%	0.556
Secondary diagnosis	Bronchitis/pneumonia/bronchopneumonia	43%	64%	44%	0.442
	Upper respiratory tract infection	35%	18%	44%	0.423
	Herpes pharyngitis/purulent tonsillitis	18%	18%	11%	0.867
	Sinusitis	11%	18%	11%	0.786
	Otitis media	1%	9%	0%	0.130
	Infantile rash	6%	0%	0%	0.528
	Diarrhea	10%	27%	0%	0.123
Imaging findings	Abnormal MRI	32%	54%	33%	0.338
	Abnormal EEG	22%	55%	89%	<0.001^a
Medication	Anticonvulsant	9%	0%	55%	<0.001^a
	Antivirals	9%	81%	33%	<0.001^b
Hospitalization	Disease duration (days)	1 (1, 2)	3 (2, 3)	1 (1, 2)	<0.001^b
	Hospital stays (days)	6 (5, 8)	12 (9, 13)	9 (6, 10)	<0.001^b

Notes: ^aMulti-comparison adjusted p value between groups of febrile seizures with epilepsy. ^bMulti-comparison adjusted p value between groups of febrile seizures with encephalitis/meningitis.

Table 2 Patients with Positive Detection in the CSF

Case No.	Sex	Age (Years)	Diagnosis at Discharge	Secondary Diagnosis	FS History	Pathogen in CSF
13	M	6	FS plus	Upper respiratory tract infection	N	H. influenzae
46	F	1.5	FS	Herpes pharyngitis	Y	HHV-6
51	M	5	FS	Herpes pharyngitis	Y	Enterovirus
121	F	1	FS	Upper respiratory tract infection	Y	EBV
48	M	1.6	Encephalitis	Herpes pharyngitis	Y	Enterovirus
17	M	1	Encephalitis	Bronchitis/purulent tonsillitis	Y	Enterovirus
60	M	4	Meningitis	Upper respiratory tract infection/Otitis media	N	S. putrefaciens*
86	M	15	Epilepsy	Pneumonia	N	M. tuberculosis
27	M	2	Epilepsy	Purulent tonsillitis	Y	S. pneumoniae

Note: *This pathogen was detected by mNGS in a child with traumatic head injury 3 days ago.