Epidemiology and etiology of meningoencephalitis in Dutch children

Meningoencephalitis in children is a rare but severe inflammation of the meninges and brain parenchyma respectively. Despite its rarity bacterial meningoencephalitis in children remains associated with high morbidity and mortality. Timely recognition and early start of treatment therefore remains important. The past decades have seen significant changes to the etiology of childhood meningoencephalitis. These changes in addition to possible areas of improvement when diagnosing meningoencephalitis in children are examined In this thesis. This thesis consists of a narrative review on the epidemiology of childhood meningoencephalitis in the Western world in the post-vaccination era and three multicenter studies focusing on specific age groups and several aspects of diagnosing meningoencephalitis in children.
In the included review we examined the several epidemiological trends and changes which were heavily influenced by the introduction of national vaccination programs against previously common bacterial causes of childhood meningoencephalitis. Additionally we take a closer look at the emergence of viral pathogens as important causes of childhood meningoencephalitis.
The three multicenter studies specifically focus on the differences in epidemiology and clinical characteristics in children with suspected or proven meningoencephalitis. Additionally, differences between specific age groups are examined more closely. In these chapters we aim to identify specific markers and clinical triggers to help with early recognition and diagnosis of childhood meningoencephalitis.
The final chapter provides an overview of the epidemiological trends and changes in diagnostic techniques over the past decades. Additionally, future opportunities for new diagnostic approaches and techniques are examined.