Clinical features and risk factors for Epstein-Barr virus-associated encephalitis: a retrospective cohort study

Clinical features and risk factors for Epstein-Barr virus-associated encephalitis: a retrospective cohort study | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Clinical features and risk factors for Epstein-Barr virus-associated encephalitis: a retrospective cohort study Zhu Liu, Anjiao Peng, Luyan Huang, Leihao Sha, Yusha Tang, Yongzhao Zhou, and 1 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-5193534/v1 This work is licensed under a CC BY 4.0 License Status: Published Journal Publication published 13 May, 2025 Read the published version in Virology Journal → Version 1 posted 6 You are reading this latest preprint version Abstract Background Epstein-Barr virus (EBV) has been gradually recognized as an important pathogen of encephalitis, but our knowledge of EBV-associated encephalitis is still limited. The aim of this study was to describe the clinical features and explore the risk factors for EBV-associated encephalitis in a large cohort of Chinese patients. Methods All patients with confirmed encephalitis in our center from June 2020 to April 2021 were enrolled. Data were extracted from the electronic medical record system and analyzed by Student's t test, Mann-Whitney U test, chi-square test, and logistic regression analyses. Results This study included a total of 364 patients diagnosed with encephalitis, among which 86 cases (23.6%) had EBV detected in their cerebrospinal fluid (CSF), and 39 cases were diagnosed with EBV-associated encephalitis. The clinical characteristics of EBV-associated encephalitis differ from those caused by other herpes viruses. Compared to other herpes virus-related encephalitis, patients with EBV encephalitis exhibited significantly higher protein levels (1.310 [0.695, 1.840] vs. 0.710 [0.490, 1.700], p < 0.001), lower glucose levels (3.030 [2.585, 3.640] vs. 3.380 [2.990, 4.030], p < 0.001), and a higher incidence of meningeal involvement on MRI (11 (30.6%) vs. 3 (6.5%), p = 0.010). Additionally, univariate logistic regression analysis revealed that age (OR = 1.015, 95% CI: 1.002–1.029), HIV infection (OR = 4.285, 95% CI: 1.582–11.816), non-tumor immunosuppression (OR = 5.713, 95% CI: 1.588–22.883), and peripheral blood EBV infection (OR = 10.204, 95% CI: 4.231–26.346) were independent risk factors for CNS EBV infection. Conclusion Compared to other herpes virus-associated encephalitis, EBV encephalitis is characterized by a higher degree of meningeal involvement, elevated CSF protein levels, lower glucose levels, and a reduced T-lymphocyte count in peripheral blood. These characteristics suggest that EBV encephalitis may have a distinct pathophysiology. Figures Figure 1 Figure 2 INTRODUCTION Encephalitis is a severe central nervous system infectious disease with an estimated incidence of 1.7–7.4 cases per 100,000 person-years worldwide. 1 The mortality of encephalitis in the acute phase has been reported to be as high as 10%, and many survivors develop long-term neurological deficits such as cognitive decline, disability, and mental illness, causing great burden to their family and the society. 2,3 Pathogens could only be determined in nearly half of patients with encephalitis and 20–50% of them are attributed to viruses. 4 Among them, herpes simplex virus, varicella-zoster virus, enteroviruses, and arboviruses-associated encephalitis have been well recognized. Epstein Barr virus (EBV), also known as human herpes virus γ, is a typical human lymphotropic herpesvirus with latent infection in B lymphocytes and productive infection in oral mucosal epithelium. 5,6 EBV has been widely recognized to cause Burkitt lymphoma, lymphoid hyperplasia disease, and nasopharyngeal carcinoma. 6 In recent years, EBV has also been found to be closely associated with autoimmune diseases such as systemic lupus erythematosus 7 and multiple sclerosis 8 . Moreover, compelling evidence has shown that EBV is an important pathogen for encephalitis, 9–13 and EBV-associated encephalitis has receiving great attention. Compared with other viruses, EBV is more likely to induce early autoimmune responses against nerve cells and causes a worse prognosis in patients with encephalitis. 14 However, our knowledge of EBV-associated encephalitis is still limited. To deepen our understanding of EBV-associated encephalitis, we conducted this retrospective cohort study and reviewed the detailed clinical features of EBV-associated encephalitis in our center. We also explored the potential risk factors for EBV-associated encephalitis. METHODS Participants With approval from the ethics committee of West China Hospital, Sichuan University, we enrolled all patients with confirmed encephalitis in our center from June 2020 to April 2021. All electronic medical records were reviewed, and the diagnoses of all patients were further confirmed by two authors (Peng and Liu) according to previous criteria. 15 Patients with symptoms consistent with meningitis and a cerebrospinal fluid (CSF) leucocyte count > 4 × 10⁶ cells per L were diagnosed with meningitis. The criteria of encephalitis were altered consciousness for > 24 h (including lethargy, irritability, or a change in personality) with no other cause found and two or more of the following signs: fever or history of fever (≥ 38°C) during the current illness; seizures or focal neurological signs (with evidence of brain parenchyma involvement); CSF pleocytosis (> 4 × 10⁶ cells per L); electroencephalogram suggesting encephalitis; and neuroimaging suggestive of encephalitis. 15 Cases without key clinical information were excluded. Data extraction A standardized form was used to extract the following information from all patients from the electronic medical record system: age, gender, consciousness, behavioral and psychological symptoms, seizure, ventilator-assisted ventilation, immunosuppression (i.e., human immunodeficiency virus infection, immunosuppressive therapy for malignant tumor (chemotherapy, radiotherapy, organ transplantation, or bone marrow transplantation), and immunosuppressive therapy for non-neoplastic condition (systemic lupus erythematosus, kidney disease, rheumatoid arthritis, etc), cell count, protein, glucose, chlorine and intrathecal IgG synthesis rate in CSF, white blood cell, lymphocyte, monocyte, CD3 + lymphocyte, CD4 + lymphocyte, and CD8 + lymphocyte, EBV copies in peripheral blood (categorized as negative; latent: positive but less than 50 copies/mL; active: more than 50 copies/mL), and findings of brain magnetic resonance imaging (MRI). Statuses at discharge were also reviewed, and those with death, persistent disturbance of consciousness or mechanical ventilation were regarded as having a poor prognosis. Data of pathogen detection EBV and other pathogens in CSF were detected by metagenomic next-generation sequencing (mNGS). We also reviewed the information of conventional testing for pathogens in CSF, brain tissue, and peripheral blood for all patients. Cryptococcal antigen assay in CSF and peripheral blood, CSF ink test examination, and CSF cryptococci culture were reviewed for cryptococcus. 16,17 CSF tuberculous smear and culture, and Mycobacterium tuberculosis and rifampicin resistance test (Xpert MTB/RIF) were reviewed for tuberculous. 18,19 CSF smear and culture were reviewed for bacteria, PCR in CSF and peripheral blood and IgM in peripheral blood were reviewed for viruses. 4 Information of other pathogens, such as John Cunningham virus, Toxoplasma gondii, and Treponema pallidum were also extracted. Statistical analysis Continuous variables were presented as median [interquartile range (IQR)] due to non-normality identified via Shapiro-Wilk tests, while categorical variables were described using frequencies (%). Group comparisons were performed using Mann-Whitney U tests for continuous variables and Chi-square tests (or Fisher's exact tests when expected cell counts < 5) for categorical variables between two groups. For subgroup analyses, EBV-positive cases were further stratified into EBV-caused and non-EBV-caused subgroups, with pairwise comparisons between EBV-negative, EBV-caused, and non-EBV-caused groups using Mann-Whitney U tests for continuous variables and Chi-square/Fisher's exact tests for categorical variables. A similar analytical approach was applied when comparing EBV-associated and other herpes virus-associated subgroups. Univariate logistic regression models were constructed to evaluate associations between candidate variables and EBV positivity, yielding odds ratios (ORs) with 95% confidence intervals (CIs). Statistical significance was defined as two-tailed p < 0.05, and data were analyzed using SPSS Statistics version 25.0 (SPSS Inc., Chicago, IL, USA). RESULTS Demographic Composition Initially, a total of 379 patients with acute encephalitis were included in the study. However, 15 patients who underwent lumbar puncture and CSF mNGS testing during emergency admission were excluded from the final analysis due to incomplete medical records caused by their spontaneous discharge and failure to re-admit. Ultimately, 364 patients were included in the study, among which 86 (23.6%) patients had EBV detected in their CSF (Table 1 ) (Fig. 1 ). Additionally, 39 patients were diagnosed with EBV-associated encephalitis, while 49 patients were diagnosed with herpes virus associated encephalitis (Table 3 ). Table 1 Clinical features between patients with or without EBV infection. Characteristic EBV positive (n = 86) EBV negative (n = 278) p value miss(%) OR 95%CI Age (years, median and IQR) 53.000 [34.000, 62.000] 47.000 [28.250, 57.000] < 0.001 - 1.015* 1.002–1.029 Gender (male, %) 63 (73.256) 180 (64.748) 0.183 - 1.491 0.882–2.592 Clinical manifestation (%) Consciousness disturbance 38 (44.186) 108 (38.849) 0.449 - 1.246 0.762–2.030 Behavioral and psychological symptoms 22 (25.581) 85 (30.576) 0.451 - 0.781 0.444–1.333 Seizure 14 (16.279) 62 (22.302) 0.294 - 0.677 0.346–1.252 Mechanical ventilation 23 (26.744) 56 (20.144) 0.251 - 1.447 0.816–2.513 Immunocompromised (%) 0.001 1.258–2.561 HIV 9 (10.465) 8 ( 2.878) - 4.285* 1.582–11.816 Malignancy 3 ( 3.488) 7 ( 2.518) - 1.632 0.345–6.041 Immunosuppression for non-neoplastic condition 6 ( 6.977) 4 ( 1.439) - 5.713* 1.588–22.883 CSF features Cell counts (median and IQR) 105.000 [20.000, 180.000] 37.500 [3.000, 157.500] < 0.001 - 1.000 1.000–1.000 Proteins (g/L, median and IQR) 1.310 [0.702, 2.077] 0.850 [0.450, 1.630] < 0.001 - 1.032 0.943–1.128 Glucose (mmol/L, median and IQR) 2.900 [2.183, 3.607] 3.290 [2.652, 4.008] < 0.001 - 0.783* 0.650–0.932 Chlorine (mmol/L, median and IQR) 121.000 [115.000, 126.000] 123.000 [116.000, 127.750] < 0.001 - 0.990 0.966–1.015 Leukocytosis (%) 72 (83.721) 200 (71.942) 0.040 - 2.006* 1.097–3.895 Proteins increasing (%) 76 (88.372) 207 (74.460) 0.010 - 2.607* 1.331–5.612 Glucose reduction (%) 27 (31.395) 59 (21.223) 0.073 - 1.699 0.983–2.895 Chlorine reduction (%) 37 (43.023) 100 (35.971) 0.293 - 1.344 0.819–2.196 Increased IgG synthesis rate (%) 32 (76.190) 77 (47.531) 0.002 44.0 3.532* 1.680–8.012 MRI features (%) Positive findings of parenchyma 40 (54.795) 118 (46.640) 0.273 10.4 1.387 0.823–2.349 Positive meningeal findings 26 (35.616) 61 (24.111) 0.071 10.4 1.741 0.988–3.032 Peripheral blood (median and IQR) White blood cells (10 9 /L) 8.325 [6.192, 10.545] 7.895 [5.920, 10.510] < 0.001 - 1.006 0.949–1.064 Lymphocytes (10 9 /L) 1.080 [0.715, 1.447] 1.165 [0.832, 1.647] < 0.001 - 0.793 0.530–1.163 Monocyte (10 9 /L) 0.660 [0.450, 0.947] 0.570 [0.422, 0.780] < 0.001 - 1.556 0.779–3.063 CD3 + T lymphocytes (cell/µl) 488.500 [318.750, 782.250] 636.000 [408.500, 935.000] < 0.001 56.9 0.999* 0.998-1.000 CD4 + T lymphocytes (cell/µl) 237.000 [129.500, 450.000] 334.000 [189.500, 518.500] < 0.001 56.9 0.998* 0.996-1.000 CD8 + T lymphocytes (cell/µl) 214.000 [96.500, 330.750] 223.000 [163.500, 377.500] < 0.001 56.9 0.998 0.996-1.000 EBV in peripheral blood (%) < 0.001 Negative 24 (41.379) 116 (74.839) Latent infection 15 (25.862) 30 (19.355) 41.5 2.417* 1.117–5.151 Active infection 19 (32.759) 9 (5.806) 41.5 10.204* 4.231–26.346 Poor prognoses (%) 0.600 Consciousness disturbance 10 (11.628) 20 (7.194) - 1.724 0.742–3.785 Mechanical ventilation 7 (8.140) 20 (7.194) - 1.207 0.457–2.855 Death 2 (2.326) 7 (2.518) - 0.985 0.144–4.190 HIV: human immunodeficiency virus; IQR: interquartile range Miss (%) If there is no missing data for the corresponding indicator, it is identified with "-", otherwise, the specific missing proportion value is displayed after it. * P <0.05 Single factor analysis was statistically significant Table 2 Clinical features among patients with encephalitis caused by EBV, with encephalitis not caused by EBV, and with encephalitis negative EBV Characteristic EBV caused (n = 39) Non-EBV caused (n = 47) EBV negative (n = 278) p value (EBV caused VS Non - EBV caused) p value (EBV caused VS EBV negative) p value (non-EBV caused VS EBV negative) Age (years, median and IQR) 55.000 [43.500, 62.500] 52.000 [32.500, 61.500] 47.000 [28.250, 57.000] <0.001 <0.001 <0.001 Gender (male, %) 28 (71.795) 35 (74.468) 180 (64.748) 0.973 0.492 0.256 Clinical manifestation (%) Consciousness disturbance 19 (48.718) 19 (40.426) 108 (38.849) 0.580 0.316 0.965 Behavioral and psychological symptoms 6 (15.385) 16 (34.043) 85 (30.576) 0.084 0.076 0.761 Seizure 5 (12.821) 9 (19.149) 62 (22.302) 0.618 0.251 0.770 Mechanical ventilation 14 (35.897) 9 (19.149) 56 (20.144) 0.133 0.044 1.000 Immunocompromised (%) 0.725 0.001 0.031 HIV 4 (10.256) 5 (10.638) 8 (2.878) Malignancy 1 (2.564) 2 (4.255) 7 (2.518) Immunosuppression for non-neoplastic condition 4 (10.256) 2 (4.255) 4 (1.439) CSF features Cell counts (median and IQR) 70.000 [6.000, 140.000] 120.000 [41.000, 287.000] 37.500 [3.000, 157.500] <0.001 <0.001 <0.001 Proteins (g/L, median and IQR) 1.310 [0.695, 1.840] 1.310 [0.795, 2.375] 0.850 [0.450, 1.630] <0.001 <0.001 <0.001 Glucose (mmol/L, median and IQR) 3.030 [2.585, 3.640] 2.670 [1.425, 3.605] 3.290 [2.652, 4.008] <0.001 <0.001 <0.001 Chlorine (mmol/L, median and IQR) 119.000 [115.000, 125.000] 121.000 [115.000, 126.000] 123.000 [116.000, 127.750] <0.001 <0.001 <0.001 Leukocytosis (%) 32 (82.051) 40 (85.106) 200 (71.942) 0.929 0.254 0.085 Proteins increasing (%) 34 (87.179) 42 (89.362) 207 (74.460) 1.000 0.123 0.041 Glucose reduction (%) 8 (20.513) 19 (40.426) 59 (21.223) 0.081 1.000 0.008 Chlorine reduction (%) 20 (51.282) 17 (36.170) 100 (35.971) 0.234 0.095 1.000 Increased IgG synthesis rate (%) 14 (77.778) 18 (75.000) 77 (47.531) 1.000 0.029 0.022 MRI features (%) Positive findings of parenchyma 19 (52.778) 21 (56.757) 118 (46.640) 0.915 0.609 0.330 Positive meningeal findings 11 (30.556) 15 (40.541) 61 (24.111) 0.518 0.528 0.055 Peripheral blood (median and IQR) White blood cells (10 9 /L) 7.790 [6.035, 10.785] 8.340 [6.485, 10.165] 7.895 [5.920, 10.510] <0.001 <0.001 <0.001 Lymphocytes (10 9 /L) 1.120 [0.665, 1.305] 1.020 [0.750, 1.525] 1.165 [0.832, 1.647] <0.001 <0.001 <0.001 Monocyte (10 9 /L) 0.660 [0.455, 0.945] 0.660 [0.425, 0.910] 0.570 [0.422, 0.780] 0.004 <0.001 <0.001 CD3 + T lymphocytes (cell/µl) 504.000 [414.000, 785.500] 453.000 [248.500, 751.000] 636.000 [408.500, 935.000] <0.001 <0.001 <0.001 CD4 + T lymphocytes (cell/µl) 254.000 [222.500, 454.500] 193.000 [119.000, 378.000] 334.000 [189.500, 518.500] <0.001 <0.001 <0.001 CD8 + T lymphocytes (cell/µl) 220.000 [101.000, 305.500] 213.000 [90.500, 327.500] 223.000 [163.500, 377.500] <0.001 <0.001 <0.001 EBV in peripheral blood (%) 0.769 < 0.001 < 0.001 Negative 15 (45.455) 9 (36.000) 116 (74.839) Latent infection 8 (24.242) 7 (28.000) 30 (19.355) Active infection 10 (30.303) 9 (36.000) 9 (5.806) Poor prognoses (%) 0.982 0.921 0.596 Consciousness disturbance 4 (10.256) 6 (12.766) 20 (7.194) Mechanical ventilation 3 (7.692) 4 (8.511) 20 (7.194) Death 1 (2.564) 1 (2.128) 7 (2.518) Table 3 Clinical features between EBV and other herpes viruses associated encephalitis. Characteristic EBV associated (n = 39) Other herpes viruses associated (n = 49) p value Age (years, median and IQR) 55.000 [43.500, 62.500] 37.000 [27.000, 57.000] <0.001 Gender (male, %) 28 (71.795) 27 (55.102) 0.166 Clinical manifestation (%) Consciousness disturbance 19 (48.718) 19 (38.776) 0.472 Behavioral and psychological symptoms 6 (15.385) 12 (24.490) 0.432 Seizure 5 (12.821) 14 (28.571) 0.128 Mechanical ventilation 14 (35.897) 10 (20.408) 0.168 Immunocompromised (%) 0.123 HIV 4 (10.256) 2 (4.082) Malignancy 1 (2.564) 0 (0.000) Immunosuppression for non-neoplastic condition 4 (10.256) 1 (2.041) CSF features Cell counts (median and IQR) 70.000 [6.000, 140.000] 50.000 [10.000, 190.000] <0.001 Proteins (g/L, median and IQR) 1.310 [0.695, 1.840] 0.710 [0.490, 1.700] <0.001 Glucose (mmol/L, median and IQR) 3.030 [2.585, 3.640] 3.380 [2.990, 4.030] <0.001 Chlorine (mmol/L, median and IQR) 119.000 [115.000, 125.000] 125.000 [120.000, 128.000] <0.001 Leukocytosis (%) 32 (82.051) 39 (79.592) 0.985 Proteins increasing (%) 34 (87.179) 38 (77.551) 0.376 Glucose reduction (%) 8 (20.513) 2 (4.082) 0.038 Chlorine reduction (%) 20 (51.282) 12 (24.490) 0.018 Increased IgG synthesis rate (%) 14 (77.778) 21 (61.765) 0.390 MRI features (%) Positive findings of parenchyma 19 (52.778) 20 (43.478) 0.593 Positive meningeal findings 11 (30.556) 3 (6.522) 0.010 Peripheral blood (median and IQR) White blood cells (10 9 /L) 7.790 [6.035, 10.785] 7.150 [6.170, 9.900] <0.001 Lymphocytes (10 9 /L) 1.120 [0.665, 1.305] 1.180 [0.700, 1.510] <0.001 Monocyte (10 9 /L) 0.660 [0.455, 0.945] 0.550 [0.440, 0.630] 0.004 CD3 + T lymphocytes (cell/ul) 504.000 [414.000, 785.500] 589.000 [458.000, 806.000] <0.001 CD4 + T lymphocytes (cell/ul) 254.000 [222.500, 454.500] 309.000 [152.000, 371.000] <0.001 CD8 + T lymphocytes (cell/ul) 220.000 [101.000, 305.500] 240.000 [176.000, 395.000] <0.001 EBV in peripheral blood (%) 0.005 Negative 15 (45.455) 27 (75.000) Latent infection 8 (24.242) 8 (22.222) Active infection 10 (30.303) 1 (2.778) Poor prognoses (%) 0.250 Consciousness disturbance 4 (10.256) 1 (2.041) Mechanical ventilation 3 (7.692) 4 (8.163) Death 1 (2.564) 0 (0.000) The EBV negative group showed relatively higher level of central nervous cryptococcus and TB (Mycobacterium tuberculosis) infections, but the prevalence of bacteria, viruses, autoimmune encephalitis antibodies (AE), and others pathogens were comparable. Clinical features between patients with or without EBV infection Generally, there was no gender difference between the two groups, but patients in EBV-positive (EBV+) group were slightly older than EBV-negative (EBV-) group (Table 1 ). There were several differences in clinical characteristics between the two groups. Firstly, immunosuppression was more common in the EBV + group compared to the EBV - group, particularly in cases of HIV infection and immunosuppression for non-neoplastic diseases. Secondly, significant differences were observed in CSF characteristics: the EBV + group had relatively higher cell counts and protein levels, while glucose and chloride levels were lower. Significant changes were also observed in peripheral blood. Compared to the EBV - group, the EBV + group exhibited significantly higher white blood cell counts and monocyte counts, while lymphocyte counts, as well as CD3+, CD4+, and CD8 + T cell counts, showed an opposite trend. EBV in peripheral blood was tested in 213 patients (58 in the EBV + group and 155 in the EBV - group). The results showed that patients with CNS EBV infection were more likely to have active peripheral EBV infection. A total of 326 patients (89.6%) completed brain MRI scans. Although the EBV + group showed more meningeal involvement on MRI, there was no statistically significant difference observed (35.6% vs. 24.1%, p >0.05) (Table 1 ). To further explore the risk factors for CNS EBV infection, logistic regression was used to calculate ORs and 95% CIs. Immunosuppression, active peripheral EBV infection, and blood cells were analyzed after age and gender adjustment. The results showed that age, immunosuppression and active infection of peripheral EBV were independent risk factors for CNS EBV infection. Pathogens were determined in a total of 181 (49.8%) patients. The results showed that compared with the EBV - group, the EBV + group had relatively higher rates of cryptococcus and tuberculosis encephalitis, but viral and bacterial infections were similar between the two groups (Fig. 2 ). Comparison of clinical features in subgroups A comparison of clinical features among three groups: EBV-positive encephalitis, EBV-positive encephalitis of other etiology, and EBV-negative encephalitis, revealed significant differences. Specifically, EBV-negative encephalitis was characterized by significantly lower values in age, CSF white blood cell count, protein level, and peripheral blood monocyte count compared to both the EBV-positive encephalitis and EBV-positive encephalitis of other etiology groups. Concurrently, the EBV-positive encephalitis group exhibited notably higher levels of CSF glucose and chloride, as well as elevated counts of peripheral blood CD3+, CD4+, and CD8 + T cells compared to the other two groups. When comparing EBV-positive encephalitis to EBV-positive encephalitis of other etiology, the former group demonstrated significantly higher values in age, CSF glucose level, peripheral blood lymphocyte and monocyte counts, as well as CD3+, CD4+, and CD8 + T cell levels. Conversely, they had lower values in CSF white blood cell count, protein level, chloride level, and peripheral blood white blood cell count. Regarding the comparison between EBV-positive encephalitis of other etiology and EBV-negative encephalitis, additional differences were observed. Notably, the presence of immunosuppression, intrathecal IgG synthesis rate in CSF, and active infection of peripheral EBV were found to be higher in the EBV-positive encephalitis of other etiology group, alongside the previously mentioned disparities in clinical features. Clinical features between EBV and other herpes viruses associated encephalitis A total of 39 patients were diagnosed with EBV-associated encephalitis among whom only EBV was detected and deemed as the pathogen. Another 49 cases were diagnosed with other herpesviruses-associated encephalitis (including 23 herpes simplex virus, 12 varicella-zoster virus, 2 cytomegalovirus, 1 human herpesvirus-6 and 11 human herpesvirus-7). Patients with EBV encephalitis tend to be older compared to those with encephalitis caused by other herpes viruses. In terms of CSF characteristics, patients with EBV encephalitis exhibit higher white blood cell counts and protein levels, while glucose and chloride levels are relatively lower. Compared to other herpes virus infections, individuals infected with EBV demonstrate higher peripheral blood white blood cell counts and monocyte counts, but lower lymphocyte, CD3+, CD4+, and CD8 + T-cell counts. This observation is similar when comparing EBV + and EBV - groups. However, a notable difference is the higher incidence of meningeal involvement among patients with EBV encephalitis. Although the prognosis of EBV encephalitis is generally poor, the results of this study did not reveal a statistically significant difference (20.5% vs. 10.2%, p >0.05) (Table 3 ). DISCUSSION The main findings of the study were as follows: 1) EBV could be found in CSF in approximately 24% of patients with acute encephalitis; 2) clinical characteristics of EBV-associated encephalitis differ from those of other herpes virus-associated encephalitis, specifically featuring leukocytosis and higher protein content, lower glucose and chloride levels in CSF, and more frequent meningeal involvement on MRI; and 3) age, immunosuppression and active peripheral EBV infection were independent risk factors for CNS EBV infection. In this retrospective cohort study, we found that EBV could be detected in CSF in nearly 24% of patients with confirmed acute encephalitis (including viral, tuberculous, bacterial, cryptococcal, and unknown cause). In line with our results, a previous study found that EBV exited the CSF of 26% of patients with bacterial meningitis using PCR. 20 Similar results from two studies with different populations and different techniques confirmed the commonness of EBV infection in acute encephalitis. Furthermore, we found that the rates of tuberculous and cryptococcal encephalitis were relatively higher in patients with CNS EBV infection, suggesting that CNS EBV may be associated with tuberculosis and cryptococcal infections, but the causal relationship deserves further research. In previous studies, glucose and chloride levels in CSF were often regarded as typical biomarkers for viral encephalitis. However, this study found that both EBV positive and negative encephalitis patients experienced varying degrees of reduction in CSF glucose and chloride levels. To eliminate interference from other pathogens such as cryptococcus and tuberculosis, we further excluded cases of related pathogen infections from the analysis, and the results still showed the presence of the aforementioned characteristics. To further investigate whether this phenomenon was limited to EBV-associated encephalitis, we selected 39 cases diagnosed with EBV-associated encephalitis from all 86 patients with EBV detected in their CSF and conducted a comparative analysis with another 49 cases of encephalitis caused by other herpes viruses. The results indicated that the decrease in glucose and chloride levels in the CSF of patients with EBV-associated encephalitis was more significant. This finding is consistent with reports in some case studies that showed reduced CSF glucose concentrations in patients with viral encephalitis. 21–23 Currently, the mechanism underlying this phenomenon is not fully understood and may be related to multiple factors, including changes in blood-brain barrier function that limit glucose entry into the subarachnoid space, the rate of glucose transport through arachnoid villi, increased glycolysis in leukocytes and bacteria, and elevated metabolic rates in the central nervous system. This phenomenon suggests that subsequent changes in CSF glucose levels in viral encephalitis may be associated with the severity of the disease. 24 Furthermore, this study found characteristics of leukocytosis and elevated protein levels in the CSF of patients with EBV-associated encephalitis, which is consistent with the findings of a previous retrospective analysis of 97 cases of EBV encephalitis. 25 It is worth noting that we also discovered that meningitis caused by the EB virus more commonly shows meningeal involvement on MRI. These manifestations further indicate that EB virus-associated encephalitis is a special type of encephalitis with characteristic presentations. Currently, the mechanism by which viruses cause encephalitis is not clear, but it is commonly believed that retrograde infection through the cranial nerve is the main pathway. However, the results of this study showed meningeal involvement on MRI in nearly 30% of patients with EBV-associated encephalitis, far higher than 6% in patients with other herpesviruses-associated encephalitis. These results suggest that destruction of the blood-brain barrier may be an important mechanism for CNS EBV infection. A major discovery in recent years is the lymphatic system in the brain, which connects the subarachnoid space, venous system, lymphatic vessels and deep cervical lymph nodes. 26–28 We infer that EBV (a typical lymphotropic herpesviruses) may enter the CNS through these channels from the peripheral lymphatic and blood system. Significantly, EBV-associated encephalitis showed more common of immunosuppression and peripheral EBV infection. The results of logistic analyses also confirmed that immunosuppression and peripheral EBV infection were independent risk factors for CNS EBV infection, implying that EBV is an opportunistic infection in the CNS. Generally, EBV lurks in B lymphocytes in adults, 5, 20 and is controlled by a sustained immune response. 29 When the immune system is disrupted, EBV may proliferate extensively and invade the CNS. This hypothesis was supported by the results that patients with CNS EBV infection showed a relatively lower average value of CD3 + and CD4 + T lymphocytes than those without CNS EBV infection. It is noteworthy that this study found a general decrease in peripheral blood CD3+, CD4+, and CD8 + T lymphocytes in patients with EBV encephalitis, suggesting a significant impact of EBV encephalitis on the immune system. Given the increasing understanding in recent years of the possibility of autoimmune encephalitis subsequent to herpes simplex encephalitis, and research indicating poor immune outcomes subsequent to EBV viral encephalitis. 14 It is essential to conduct relevant tests such as NMDA receptor antibody testing for patients with EBV encephalitis, if necessary, to provide a theoretical basis for combined immunotherapy. 30 Limitations First, due to the limitations of mNGS itself, we could not rule out the possibility of false positives or false negatives, but similar results from different analyses confirmed the robustness of the results. Second, some patients in our center were transferred from other regional hospitals, and many of them received antiviral treatment before arriving our center. Thus, the positive rate of EBV in untreated encephalitis patients may be higher than that reported here. Third, EBV can be detected in many patients with tuberculous, cryptococcal, or bacterial encephalitis, but the causal relationship between EBV and these pathogens needed to be explored in further studies. Finally, it is important to note that the data were collected during the COVID-19 pandemic, a period when lower circulating infections in society may have affected the prevalence of infections observed in our study. This potential limitation should be considered when interpreting the results. CONCLUSIONS Our results indicate that EBV infection is common and may be an opportunistic infection in patients with encephalitis, which may enter CNS mainly through the destruction of the blood-brain barrier. EBV-associated encephalitis is characterized by relatively reduced glucose and chloride levels, and more meningeal involvement on MRI than other herpesviruses-associated encephalitis. Declarations Author Contributions concept and design, Yongzhao Zhou. and Anjiao Peng; drafting of the manuscript and interpretation of data, Zhu Liu. and Luyan Huang; data acquisition, analysis, Yusha Tang; data analysis, Leihao Sha; critical revision of the manuscript for intellectual content; study supervision, Lei Chen. All authors have read and agreed to the published version of the manuscript. Ethics approval and consent to participate This study has been approved by the Ethics Committee of West China Hospital, Sichuan University (No. 2022-857). Our data are extracted from the electronic medical record system and do not involve patient privacy, so a patient consent statement is not needed. Availability of data and materials The data supporting the findings of this study are available upon reasonable request from the corresponding author. Funding statement This study was supported fund of West China Hospital of Sichuan University and University of Electronic Science and technology (No. HXDZ21006), and the National Natural Science Foundation of China (82201752). Competing interests The authors declare no competing interests. Consent for publication Not applicable. Acknowledgments Not applicable References GBD 2013 Mortality and Causes of Death Collaborators. Global, regional, and national age-sex specific all-cause and cause-specific mortality for 240 causes of death, 1990–2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet. 2015 Jan 10;385(9963):117–171. Mailles A, De Broucker T, Costanzo P, et al. Long-term outcome of patients presenting with acute infectious encephalitis of various causes in France. Clin Infect Dis. 2012 May;54(10):1455–1464. Venkatesan A. Epidemiology and outcomes of acute encephalitis. Curr Opin Neurol. 2015 Jun;28(3):277–282. Tyler KL. Acute Viral Encephalitis. N Engl J Med. 2018 Aug 9;379(6):557–566. Thorley-Lawson DA. EBV Persistence–Introducing the Virus. Curr Top Microbiol Immunol. 2015;390(Pt 1):151–209. Shannon-Lowe C, Rickinson A. The Global Landscape of EBV-Associated Tumors. Front Oncol. 2019 Aug 6;9:713. Zhang F, Zhang B, Ding H, et al. The Oxysterol Receptor EBI2 Links Innate and Adaptive Immunity to Limit IFN Response and Systemic Lupus Erythematosus. Adv Sci (Weinh). 2023 Sep;10(27):e2207108. Debuysschere C, Nekoua MP, Hober D. Markers of Epstein-Barr Virus Infection in Patients with Multiple Sclerosis. Microorganisms. 2023 May 11;11(5):1262. Tsuruyama Y, Mori N, Yoshida S, et al. Epstein-Barr virus-related encephalitis in a young woman: A case report. J Infect Chemother. 2020 Jul;26(7):741–744. Nakamura J, Yanagida M, Saito K, et al. Epstein-Barr virus encephalitis in a patient with rheumatoid arthritis. Mod Rheumatol Case Rep. 2022 Jun 24;6(2):160–162. Patnaik S, Samal P, Sahoo A, et al. A fulminant case of Epstein-Barr Virus encephalitis with multiorgan dysfunction. J Neurovirol. 2022 Jun;28(3):464–466. Zhao H, Zhang X, Yang H, Gu J. Epstein-Barr virus encephalitis with excessive daytime sleepiness as the main manifestation: Two case reports. Medicine (Baltimore). 2022 Aug 26;101(34):e30327. Schwenkenbecher P, Skripuletz T, Lange P, et al. Intrathecal Antibody Production Against Epstein-Barr, Herpes Simplex, and Other Neurotropic Viruses in Autoimmune Encephalitis. Neurol Neuroimmunol Neuroinflamm. 2021 Aug 24;8(6):e1062. Liu D, Lin PH, Li HL, et al. Early autoimmunity and outcome in virus encephalitis: a retrospective study based on tissue-based assay. J Neurol Neurosurg Psychiatry. 2023 Aug;94(8):605–613. McGill F, Griffiths MJ, Bonnett LJ, et al. UK Meningitis Study Investigators. Incidence, aetiology, and sequelae of viral meningitis in UK adults: a multicentre prospective observational cohort study. Lancet Infect Dis. 2018 Sep;18(9):992–1003. Guidelines for The Diagnosis, Prevention and Management of Cryptococcal Disease in HIV-Infected Adults, Adolescents and Children: Supplement to the 2016 Consolidated Guidelines on the Use of Antiretroviral Drugs for Treating and Preventing HIV Infection. Geneva: World Health Organization; 2018 Mar. Stott KE, Loyse A, Jarvis JN, et al. Cryptococcal meningoencephalitis: time for action. Lancet Infect Dis. 2021 Sep;21(9):e259-e271. Schaller MA, Wicke F, Foerch C, Weidauer S. Central Nervous System Tuberculosis : Etiology, Clinical Manifestations and Neuroradiological Features. Clin Neuroradiol. 2019 Mar;29(1):3–18. Ssebambulidde K, Bangdiwala AS, Kwizera R, et al. Symptomatic Cryptococcal Antigenemia Presenting as Early Cryptococcal Meningitis With Negative Cerebral Spinal Fluid Analysis. Clin Infect Dis. 2019 May 30;68(12):2094–2098. Kelly MJ, Benjamin LA, Cartwright K, et al. Epstein-barr virus coinfection in cerebrospinal fluid is associated with increased mortality in Malawian adults with bacterial meningitis. J Infect Dis. 2012 Jan 1;205(1):106 − 10. Cao LJ, Zheng YM, Li F, et al. Varicella-zoster virus meningitis with hypoglycorrhachia: A case report. World J Clin Cases. 2023 Oct 16;11(29):7101–7106. Fadhel M, Campbell N, Patel S, et al. Varicella Zoster Meningitis with Hypoglycorrhachia on Cerebrospinal Fluid (CSF) Analysis in a Young Immunocompetent Host without a Rash. Am J Case Rep. 2019 May 16;20:701–704. Spernovasilis N, Milioni A, Gialamas I,et al. Varicella-zoster virus meningitis with hypoglycorrhachia in a young immunocompetent adult without rash: A case report and literature review. IDCases. 2018 Apr 13;12:104–106. Shrikanth V, Salazar L, Khoury N, et al. Hypoglycorrhachia in adults with community-acquired meningitis: etiologies and prognostic significance. Int J Infect Dis. 2015 Oct;39:39–43. Peuchmaur M, Voisin J, Vaillant M, et al. Epstein-Barr Virus Encephalitis: A Review of Case Reports from the Last 25 Years. Microorganisms. 2023 Nov 21;11(12):2825. Wei CJ, Yassine HM, McTamney PM, et al. Elicitation of broadly neutralizing influenza antibodies in animals with previous influenza exposure. Sci Transl Med. 2012 Aug 15;4(147):147ra114. Aspelund A, Antila S, Proulx ST, et al. A dural lymphatic vascular system that drains brain interstitial fluid and macromolecules. J Exp Med. 2015 Jun 29;212(7):991–999. Louveau A, Smirnov I, Keyes TJ, et al. Structural and functional features of central nervous system lymphatic vessels. Nature. 2015 Jul 16;523(7560):337–341. Afrasiabi A, Parnell GP, Fewings N, et al. Evidence from genome wide association studies implicates reduced control of Epstein-Barr virus infection in multiple sclerosis susceptibility. Genome Med. 2019 Apr 30;11(1):26. Venkatesan A, Michael BD, Probasco JC, et al. Acute encephalitis in immunocompetent adults. Lancet. 2019 Feb 16;393(10172):702–716. Additional Declarations No competing interests reported. Cite Share Download PDF Status: Published Journal Publication published 13 May, 2025 Read the published version in Virology Journal → Version 1 posted Editorial decision: Accepted 28 Apr, 2025 Reviews received at journal 28 Apr, 2025 Reviewers agreed at journal 21 Apr, 2025 Reviewers invited by journal 16 Apr, 2025 Submission checks completed at journal 08 Apr, 2025 First submitted to journal 05 Apr, 2025 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-5193534","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":443847395,"identity":"8ceb8160-bd00-4f4b-bfa0-3e10bf52f222","order_by":0,"name":"Zhu Liu","email":"","orcid":"","institution":"West China Hospital of Sichuan University","correspondingAuthor":false,"prefix":"","firstName":"Zhu","middleName":"","lastName":"Liu","suffix":""},{"id":443847396,"identity":"383ad95d-cfa1-4b4f-9b2d-726cde954c01","order_by":1,"name":"Anjiao Peng","email":"","orcid":"","institution":"West China Hospital of Sichuan University","correspondingAuthor":false,"prefix":"","firstName":"Anjiao","middleName":"","lastName":"Peng","suffix":""},{"id":443847397,"identity":"3ae471aa-fd51-4a80-b336-4cc1f4ad6ee8","order_by":2,"name":"Luyan Huang","email":"","orcid":"","institution":"West China Hospital of Sichuan University","correspondingAuthor":false,"prefix":"","firstName":"Luyan","middleName":"","lastName":"Huang","suffix":""},{"id":443847398,"identity":"5bc41b47-e1d2-40bc-b729-8695932fc4e7","order_by":3,"name":"Leihao Sha","email":"","orcid":"","institution":"West China Hospital of Sichuan University","correspondingAuthor":false,"prefix":"","firstName":"Leihao","middleName":"","lastName":"Sha","suffix":""},{"id":443847399,"identity":"a4db6f54-5019-47fc-b554-6ed04a679a96","order_by":4,"name":"Yusha Tang","email":"","orcid":"","institution":"West China Hospital of Sichuan University","correspondingAuthor":false,"prefix":"","firstName":"Yusha","middleName":"","lastName":"Tang","suffix":""},{"id":443847400,"identity":"71d4556b-62c6-429e-87d4-4d7c13933462","order_by":5,"name":"Yongzhao Zhou","email":"","orcid":"","institution":"West China Hospital of Sichuan University","correspondingAuthor":false,"prefix":"","firstName":"Yongzhao","middleName":"","lastName":"Zhou","suffix":""},{"id":443847401,"identity":"b4b47df4-314c-4ab9-a3a1-07b822673fc9","order_by":6,"name":"Lei Chen","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA0UlEQVRIie3QMQrCMBTG8S8I1iHoWhHqCYQnBcFFzxIcXDu6+UpBF8G14CWcdE3p4BUUFzu5duxQ0Ardk9EhfwhZ8oP3Arhcf1gfItYgBMt9HL9KG9KF4B8JSebJNLUjgG6OOvvr3ahnRbyEdRlBXIcFj4BFMGETkRlnKaEzPykOI6zCmTYRX3EuqRnwqXiVQquLkYwLzmuCxCNrrBXxBefNj/l0F3FiR6Ti7ECg4UElIiWLXQberXhVNbZH7/auys0iMJK2T3uT3XOXy+VyGfoC9pRC1Y0Wj70AAAAASUVORK5CYII=","orcid":"","institution":"Sichuan University","correspondingAuthor":true,"prefix":"","firstName":"Lei","middleName":"","lastName":"Chen","suffix":""}],"badges":[],"createdAt":"2024-10-02 14:38:20","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-5193534/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-5193534/v1","draftVersion":[],"editorialEvents":[{"content":"https://doi.org/10.1186/s12985-025-02768-w","type":"published","date":"2025-05-13T15:57:54+00:00"}],"editorialNote":"","failedWorkflow":false,"files":[{"id":80996971,"identity":"c50a5f3d-63c6-4853-9dcf-9174a5323816","added_by":"auto","created_at":"2025-04-21 05:33:36","extension":"jpeg","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":199490,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cstrong\u003eThe inclusion flow chart.\u003c/strong\u003e\u003c/p\u003e","description":"","filename":"floatimage1.jpeg","url":"https://assets-eu.researchsquare.com/files/rs-5193534/v1/ba4d9bac7e4fbfb3ac5fc862.jpeg"},{"id":80996969,"identity":"033e2d49-2e90-4227-bb90-b8c1ab23e589","added_by":"auto","created_at":"2025-04-21 05:33:35","extension":"png","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":33169,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cstrong\u003eThe prevalence of Epstein Barr virus (EBV) in encephalitis with confirmed pathogens.\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe EBV negative group showed relatively higher level of central nervous cryptococcus and TB (Mycobacterium tuberculosis) infections, but the prevalence of bacteria, viruses, autoimmune encephalitis antibodies (AE), and others pathogens were comparable.\u003c/p\u003e","description":"","filename":"floatimage2.png","url":"https://assets-eu.researchsquare.com/files/rs-5193534/v1/b8119f70df28f51459b129ea.png"},{"id":83067880,"identity":"4be5031e-0282-4893-a901-fd011735fc54","added_by":"auto","created_at":"2025-05-19 16:07:29","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1829595,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-5193534/v1/6a234306-efff-4ab9-989c-00a057de1125.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Clinical features and risk factors for Epstein-Barr virus-associated encephalitis: a retrospective cohort study","fulltext":[{"header":"INTRODUCTION","content":"\u003cp\u003eEncephalitis is a severe central nervous system infectious disease with an estimated incidence of 1.7\u0026ndash;7.4 cases per 100,000 person-years worldwide.\u003csup\u003e1\u003c/sup\u003e The mortality of encephalitis in the acute phase has been reported to be as high as 10%, and many survivors develop long-term neurological deficits such as cognitive decline, disability, and mental illness, causing great burden to their family and the society.\u003csup\u003e2,3\u003c/sup\u003e Pathogens could only be determined in nearly half of patients with encephalitis and 20\u0026ndash;50% of them are attributed to viruses.\u003csup\u003e4\u003c/sup\u003e Among them, herpes simplex virus, varicella-zoster virus, enteroviruses, and arboviruses-associated encephalitis have been well recognized.\u003c/p\u003e \u003cp\u003eEpstein Barr virus (EBV), also known as human herpes virus γ, is a typical human lymphotropic herpesvirus with latent infection in B lymphocytes and productive infection in oral mucosal epithelium.\u003csup\u003e5,6\u003c/sup\u003e EBV has been widely recognized to cause Burkitt lymphoma, lymphoid hyperplasia disease, and nasopharyngeal carcinoma.\u003csup\u003e6\u003c/sup\u003e In recent years, EBV has also been found to be closely associated with autoimmune diseases such as systemic lupus erythematosus\u003csup\u003e7\u003c/sup\u003e and multiple sclerosis\u003csup\u003e8\u003c/sup\u003e. Moreover, compelling evidence has shown that EBV is an important pathogen for encephalitis,\u003csup\u003e9\u0026ndash;13\u003c/sup\u003e and EBV-associated encephalitis has receiving great attention. Compared with other viruses, EBV is more likely to induce early autoimmune responses against nerve cells and causes a worse prognosis in patients with encephalitis.\u003csup\u003e14\u003c/sup\u003e However, our knowledge of EBV-associated encephalitis is still limited.\u003c/p\u003e \u003cp\u003eTo deepen our understanding of EBV-associated encephalitis, we conducted this retrospective cohort study and reviewed the detailed clinical features of EBV-associated encephalitis in our center. We also explored the potential risk factors for EBV-associated encephalitis.\u003c/p\u003e"},{"header":"METHODS","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003eParticipants\u003c/h2\u003e \u003cp\u003e With approval from the ethics committee of West China Hospital, Sichuan University, we enrolled all patients with confirmed encephalitis in our center from June 2020 to April 2021. All electronic medical records were reviewed, and the diagnoses of all patients were further confirmed by two authors (Peng and Liu) according to previous criteria.\u003csup\u003e15\u003c/sup\u003e Patients with symptoms consistent with meningitis and a cerebrospinal fluid (CSF) leucocyte count\u0026thinsp;\u0026gt;\u0026thinsp;4 \u0026times; 10⁶ cells per L were diagnosed with meningitis. The criteria of encephalitis were altered consciousness for \u0026gt;\u0026thinsp;24 h (including lethargy, irritability, or a change in personality) with no other cause found and two or more of the following signs: fever or history of fever (\u0026ge;\u0026thinsp;38\u0026deg;C) during the current illness; seizures or focal neurological signs (with evidence of brain parenchyma involvement); CSF pleocytosis (\u0026gt;\u0026thinsp;4 \u0026times; 10⁶ cells per L); electroencephalogram suggesting encephalitis; and neuroimaging suggestive of encephalitis.\u003csup\u003e15\u003c/sup\u003e Cases without key clinical information were excluded.\u003c/p\u003e \u003c/div\u003e\n\u003ch3\u003eData extraction\u003c/h3\u003e\n\u003cp\u003eA standardized form was used to extract the following information from all patients from the electronic medical record system: age, gender, consciousness, behavioral and psychological symptoms, seizure, ventilator-assisted ventilation, immunosuppression (i.e., human immunodeficiency virus infection, immunosuppressive therapy for malignant tumor (chemotherapy, radiotherapy, organ transplantation, or bone marrow transplantation), and immunosuppressive therapy for non-neoplastic condition (systemic lupus erythematosus, kidney disease, rheumatoid arthritis, etc), cell count, protein, glucose, chlorine and intrathecal IgG synthesis rate in CSF, white blood cell, lymphocyte, monocyte, CD3\u0026thinsp;+\u0026thinsp;lymphocyte, CD4\u0026thinsp;+\u0026thinsp;lymphocyte, and CD8\u0026thinsp;+\u0026thinsp;lymphocyte, EBV copies in peripheral blood (categorized as negative; latent: positive but less than 50 copies/mL; active: more than 50 copies/mL), and findings of brain magnetic resonance imaging (MRI). Statuses at discharge were also reviewed, and those with death, persistent disturbance of consciousness or mechanical ventilation were regarded as having a poor prognosis.\u003c/p\u003e\n\u003ch3\u003eData of pathogen detection\u003c/h3\u003e\n\u003cp\u003eEBV and other pathogens in CSF were detected by metagenomic next-generation sequencing (mNGS). We also reviewed the information of conventional testing for pathogens in CSF, brain tissue, and peripheral blood for all patients. Cryptococcal antigen assay in CSF and peripheral blood, CSF ink test examination, and CSF cryptococci culture were reviewed for cryptococcus.\u003csup\u003e16,17\u003c/sup\u003e CSF tuberculous smear and culture, and Mycobacterium tuberculosis and rifampicin resistance test (Xpert MTB/RIF) were reviewed for tuberculous.\u003csup\u003e18,19\u003c/sup\u003e CSF smear and culture were reviewed for bacteria, PCR in CSF and peripheral blood and IgM in peripheral blood were reviewed for viruses.\u003csup\u003e4\u003c/sup\u003e Information of other pathogens, such as John Cunningham virus, Toxoplasma gondii, and Treponema pallidum were also extracted.\u003c/p\u003e \u003cdiv id=\"Sec6\" class=\"Section2\"\u003e \u003ch2\u003eStatistical analysis\u003c/h2\u003e \u003cp\u003eContinuous variables were presented as median [interquartile range (IQR)] due to non-normality identified via Shapiro-Wilk tests, while categorical variables were described using frequencies (%). Group comparisons were performed using Mann-Whitney U tests for continuous variables and Chi-square tests (or Fisher's exact tests when expected cell counts\u0026thinsp;\u0026lt;\u0026thinsp;5) for categorical variables between two groups.\u003c/p\u003e \u003cp\u003eFor subgroup analyses, EBV-positive cases were further stratified into EBV-caused and non-EBV-caused subgroups, with pairwise comparisons between EBV-negative, EBV-caused, and non-EBV-caused groups using Mann-Whitney U tests for continuous variables and Chi-square/Fisher's exact tests for categorical variables. A similar analytical approach was applied when comparing EBV-associated and other herpes virus-associated subgroups.\u003c/p\u003e \u003cp\u003eUnivariate logistic regression models were constructed to evaluate associations between candidate variables and EBV positivity, yielding odds ratios (ORs) with 95% confidence intervals (CIs). Statistical significance was defined as two-tailed \u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.05, and data were analyzed using SPSS Statistics version 25.0 (SPSS Inc., Chicago, IL, USA).\u003c/p\u003e \u003c/div\u003e"},{"header":"RESULTS","content":"\u003cdiv id=\"Sec8\" class=\"Section2\"\u003e \u003ch2\u003eDemographic Composition\u003c/h2\u003e \u003cp\u003eInitially, a total of 379 patients with acute encephalitis were included in the study. However, 15 patients who underwent lumbar puncture and CSF mNGS testing during emergency admission were excluded from the final analysis due to incomplete medical records caused by their spontaneous discharge and failure to re-admit. Ultimately, 364 patients were included in the study, among which 86 (23.6%) patients had EBV detected in their CSF (Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e) (Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003e). Additionally, 39 patients were diagnosed with EBV-associated encephalitis, while 49 patients were diagnosed with herpes virus associated encephalitis (Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eClinical features between patients with or without EBV infection.\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"7\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCharacteristic\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eEBV positive (n\u0026thinsp;=\u0026thinsp;86)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eEBV negative (n\u0026thinsp;=\u0026thinsp;278)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003ep value\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003emiss(%)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003eOR\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e \u003cp\u003e95%CI\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAge (years, median and IQR)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e53.000 [34.000, 62.000]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e47.000 [28.250, 57.000]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e-\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e1.015*\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e1.002\u0026ndash;1.029\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGender (male, %)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e63 (73.256)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e180 (64.748)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.183\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e1.491\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.882\u0026ndash;2.592\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eClinical manifestation (%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eConsciousness disturbance\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e38 (44.186)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e108 (38.849)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.449\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e1.246\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.762\u0026ndash;2.030\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBehavioral and psychological symptoms\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e22 (25.581)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e85 (30.576)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.451\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.781\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.444\u0026ndash;1.333\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSeizure\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e14 (16.279)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e62 (22.302)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.294\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.677\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.346\u0026ndash;1.252\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMechanical ventilation\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e23 (26.744)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e56 (20.144)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.251\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e1.447\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.816\u0026ndash;2.513\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eImmunocompromised (%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e1.258\u0026ndash;2.561\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHIV\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e9 (10.465)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e8 ( 2.878)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e4.285*\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e1.582\u0026ndash;11.816\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMalignancy\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e3 ( 3.488)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e7 ( 2.518)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e1.632\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.345\u0026ndash;6.041\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eImmunosuppression for non-neoplastic condition\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e6 ( 6.977)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e4 ( 1.439)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e5.713*\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e1.588\u0026ndash;22.883\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCSF features\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCell counts (median and IQR)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e105.000 [20.000, 180.000]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e37.500 [3.000, 157.500]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e-\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e1.000\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e1.000\u0026ndash;1.000\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eProteins (g/L, median and IQR)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1.310 [0.702, 2.077]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.850 [0.450, 1.630]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e-\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e1.032\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.943\u0026ndash;1.128\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGlucose (mmol/L, median and IQR)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e2.900 [2.183, 3.607]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e3.290 [2.652, 4.008]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e-\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.783*\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.650\u0026ndash;0.932\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eChlorine (mmol/L, median and IQR)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e121.000 [115.000, 126.000]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e123.000 [116.000, 127.750]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e-\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.990\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.966\u0026ndash;1.015\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLeukocytosis (%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e72 (83.721)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e200 (71.942)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e0.040\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e-\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e2.006*\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e1.097\u0026ndash;3.895\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eProteins increasing (%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e76 (88.372)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e207 (74.460)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e0.010\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e-\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e2.607*\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e1.331\u0026ndash;5.612\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGlucose reduction (%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e27 (31.395)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e59 (21.223)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e0.073\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e-\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e1.699\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.983\u0026ndash;2.895\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eChlorine reduction (%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e37 (43.023)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e100 (35.971)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e0.293\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e-\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e1.344\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.819\u0026ndash;2.196\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eIncreased IgG synthesis rate (%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e32 (76.190)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e77 (47.531)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e0.002\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e44.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e3.532*\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e1.680\u0026ndash;8.012\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMRI features (%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePositive findings of parenchyma\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e40 (54.795)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e118 (46.640)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.273\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e10.4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e1.387\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.823\u0026ndash;2.349\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePositive meningeal findings\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e26 (35.616)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e61 (24.111)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.071\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e10.4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e1.741\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.988\u0026ndash;3.032\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePeripheral blood (median and IQR)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWhite blood cells (10\u003csup\u003e9\u003c/sup\u003e/L)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e8.325 [6.192, 10.545]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e7.895 [5.920, 10.510]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e-\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e1.006\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.949\u0026ndash;1.064\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLymphocytes (10\u003csup\u003e9\u003c/sup\u003e/L)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1.080 [0.715, 1.447]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1.165 [0.832, 1.647]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e-\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.793\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.530\u0026ndash;1.163\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMonocyte (10\u003csup\u003e9\u003c/sup\u003e/L)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e0.660 [0.450, 0.947]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.570 [0.422, 0.780]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e-\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e1.556\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.779\u0026ndash;3.063\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCD3\u0026thinsp;+\u0026thinsp;T lymphocytes (cell/\u0026micro;l)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e488.500 [318.750, 782.250]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e636.000 [408.500, 935.000]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e56.9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.999*\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.998-1.000\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCD4\u0026thinsp;+\u0026thinsp;T lymphocytes (cell/\u0026micro;l)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e237.000 [129.500, 450.000]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e334.000 [189.500, 518.500]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e56.9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.998*\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.996-1.000\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCD8\u0026thinsp;+\u0026thinsp;T lymphocytes (cell/\u0026micro;l)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e214.000 [96.500, 330.750]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e223.000 [163.500, 377.500]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e56.9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.998\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.996-1.000\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEBV in peripheral blood (%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNegative\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e24 (41.379)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e116 (74.839)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLatent infection\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e15 (25.862)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e30 (19.355)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e41.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e2.417*\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e1.117\u0026ndash;5.151\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eActive infection\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e19 (32.759)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e9 (5.806)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e41.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e10.204*\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e4.231\u0026ndash;26.346\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePoor prognoses (%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.600\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eConsciousness disturbance\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e10 (11.628)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e20 (7.194)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e1.724\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.742\u0026ndash;3.785\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMechanical ventilation\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e7 (8.140)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e20 (7.194)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e1.207\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.457\u0026ndash;2.855\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDeath\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e2 (2.326)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e7 (2.518)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.985\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.144\u0026ndash;4.190\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"7\"\u003eHIV: human immunodeficiency virus; IQR: interquartile range\u003c/td\u003e\u003c/tr\u003e \u003ctr\u003e\u003ctd colspan=\"7\"\u003eMiss (%) If there is no missing data for the corresponding indicator, it is identified with \"-\", otherwise, the specific missing proportion value is displayed after it.\u003c/td\u003e\u003c/tr\u003e \u003ctr\u003e\u003ctd colspan=\"7\"\u003e* \u003cem\u003eP\u003c/em\u003e\u0026lt;0.05 Single factor analysis was statistically significant\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eClinical features among patients with encephalitis caused by EBV, with encephalitis not caused by EBV, and with encephalitis negative EBV\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"7\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCharacteristic\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eEBV caused\u003c/p\u003e \u003cp\u003e(n\u0026thinsp;=\u0026thinsp;39)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eNon-EBV caused\u003c/p\u003e \u003cp\u003e(n\u0026thinsp;=\u0026thinsp;47)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eEBV negative\u003c/p\u003e \u003cp\u003e(n\u0026thinsp;=\u0026thinsp;278)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003ep value\u003c/p\u003e \u003cp\u003e(EBV caused VS Non - EBV caused)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003ep value\u003c/p\u003e \u003cp\u003e(EBV caused VS EBV negative)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e \u003cp\u003ep value\u003c/p\u003e \u003cp\u003e(non-EBV caused VS EBV negative)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAge (years, median and IQR)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e55.000 [43.500, 62.500]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e52.000 [32.500, 61.500]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e47.000 [28.250, 57.000]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGender (male, %)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e28 (71.795)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e35 (74.468)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e180 (64.748)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.973\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.492\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.256\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eClinical manifestation (%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eConsciousness disturbance\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e19 (48.718)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e19 (40.426)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e108 (38.849)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.580\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.316\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.965\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBehavioral and psychological symptoms\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e6 (15.385)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e16 (34.043)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e85 (30.576)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.084\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.076\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.761\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSeizure\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e5 (12.821)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e9 (19.149)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e62 (22.302)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.618\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.251\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.770\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMechanical ventilation\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e14 (35.897)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e9 (19.149)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e56 (20.144)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.133\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003e0.044\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e1.000\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eImmunocompromised (%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.725\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003e0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e\u003cb\u003e0.031\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHIV\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e4 (10.256)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e5 (10.638)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e8 (2.878)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMalignancy\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1 (2.564)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e2 (4.255)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e7 (2.518)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eImmunosuppression for non-neoplastic condition\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e4 (10.256)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e2 (4.255)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e4 (1.439)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCSF features\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCell counts (median and IQR)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e70.000 [6.000, 140.000]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e120.000 [41.000, 287.000]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e37.500 [3.000, 157.500]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eProteins (g/L, median and IQR)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1.310 [0.695, 1.840]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1.310 [0.795, 2.375]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.850 [0.450, 1.630]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGlucose (mmol/L, median and IQR)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e3.030 [2.585, 3.640]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e2.670 [1.425, 3.605]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e3.290 [2.652, 4.008]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eChlorine (mmol/L, median and IQR)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e119.000 [115.000, 125.000]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e121.000 [115.000, 126.000]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e123.000 [116.000, 127.750]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLeukocytosis (%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e32 (82.051)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e40 (85.106)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e200 (71.942)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.929\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.254\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.085\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eProteins increasing (%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e34 (87.179)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e42 (89.362)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e207 (74.460)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e1.000\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.123\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e\u003cb\u003e0.041\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGlucose reduction (%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e8 (20.513)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e19 (40.426)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e59 (21.223)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.081\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e1.000\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e\u003cb\u003e0.008\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eChlorine reduction (%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e20 (51.282)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e17 (36.170)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e100 (35.971)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.234\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.095\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e1.000\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eIncreased IgG synthesis rate (%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e14 (77.778)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e18 (75.000)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e77 (47.531)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e1.000\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003e0.029\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e\u003cb\u003e0.022\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMRI features (%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePositive findings of parenchyma\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e19 (52.778)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e21 (56.757)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e118 (46.640)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.915\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.609\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.330\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePositive meningeal findings\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e11 (30.556)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e15 (40.541)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e61 (24.111)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.518\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.528\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.055\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePeripheral blood (median and IQR)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWhite blood cells (10\u003csup\u003e9\u003c/sup\u003e/L)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e7.790 [6.035, 10.785]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e8.340 [6.485, 10.165]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e7.895 [5.920, 10.510]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLymphocytes (10\u003csup\u003e9\u003c/sup\u003e/L)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1.120 [0.665, 1.305]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1.020 [0.750, 1.525]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e1.165 [0.832, 1.647]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMonocyte (10\u003csup\u003e9\u003c/sup\u003e/L)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e0.660 [0.455, 0.945]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.660 [0.425, 0.910]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.570 [0.422, 0.780]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e0.004\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCD3\u0026thinsp;+\u0026thinsp;T lymphocytes (cell/\u0026micro;l)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e504.000 [414.000, 785.500]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e453.000 [248.500, 751.000]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e636.000 [408.500, 935.000]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCD4\u0026thinsp;+\u0026thinsp;T lymphocytes (cell/\u0026micro;l)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e254.000 [222.500, 454.500]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e193.000 [119.000, 378.000]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e334.000 [189.500, 518.500]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCD8\u0026thinsp;+\u0026thinsp;T lymphocytes (cell/\u0026micro;l)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e220.000 [101.000, 305.500]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e213.000 [90.500, 327.500]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e223.000 [163.500, 377.500]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEBV in peripheral blood (%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.769\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNegative\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e15 (45.455)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e9 (36.000)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e116 (74.839)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLatent infection\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e8 (24.242)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e7 (28.000)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e30 (19.355)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eActive infection\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e10 (30.303)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e9 (36.000)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e9 (5.806)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePoor prognoses (%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.982\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.921\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.596\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eConsciousness disturbance\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e4 (10.256)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e6 (12.766)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e20 (7.194)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMechanical ventilation\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e3 (7.692)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e4 (8.511)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e20 (7.194)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDeath\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1 (2.564)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1 (2.128)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e7 (2.518)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eClinical features between EBV and other herpes viruses associated encephalitis.\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"4\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCharacteristic\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eEBV associated\u003c/p\u003e \u003cp\u003e(n\u0026thinsp;=\u0026thinsp;39)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eOther herpes viruses associated (n\u0026thinsp;=\u0026thinsp;49)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003ep value\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAge (years, median and IQR)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e55.000 [43.500, 62.500]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e37.000 [27.000, 57.000]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGender (male, %)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e28 (71.795)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e27 (55.102)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.166\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eClinical manifestation (%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eConsciousness disturbance\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e19 (48.718)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e19 (38.776)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.472\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBehavioral and psychological symptoms\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e6 (15.385)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e12 (24.490)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.432\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSeizure\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e5 (12.821)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e14 (28.571)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.128\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMechanical ventilation\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e14 (35.897)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e10 (20.408)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.168\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eImmunocompromised (%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.123\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHIV\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e4 (10.256)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e2 (4.082)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMalignancy\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1 (2.564)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0 (0.000)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eImmunosuppression for non-neoplastic condition\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e4 (10.256)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1 (2.041)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCSF features\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCell counts (median and IQR)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e70.000 [6.000, 140.000]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e50.000 [10.000, 190.000]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eProteins (g/L, median and IQR)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1.310 [0.695, 1.840]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.710 [0.490, 1.700]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGlucose (mmol/L, median and IQR)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e3.030 [2.585, 3.640]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e3.380 [2.990, 4.030]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eChlorine (mmol/L, median and IQR)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e119.000 [115.000, 125.000]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e125.000 [120.000, 128.000]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLeukocytosis (%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e32 (82.051)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e39 (79.592)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.985\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eProteins increasing (%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e34 (87.179)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e38 (77.551)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.376\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGlucose reduction (%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e8 (20.513)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e2 (4.082)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e0.038\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eChlorine reduction (%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e20 (51.282)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e12 (24.490)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e0.018\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eIncreased IgG synthesis rate (%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e14 (77.778)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e21 (61.765)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.390\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMRI features (%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePositive findings of parenchyma\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e19 (52.778)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e20 (43.478)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.593\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePositive meningeal findings\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e11 (30.556)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e3 (6.522)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e0.010\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePeripheral blood (median and IQR)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWhite blood cells (10\u003csup\u003e9\u003c/sup\u003e/L)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e7.790 [6.035, 10.785]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e7.150 [6.170, 9.900]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLymphocytes (10\u003csup\u003e9\u003c/sup\u003e/L)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1.120 [0.665, 1.305]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1.180 [0.700, 1.510]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMonocyte (10\u003csup\u003e9\u003c/sup\u003e/L)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e0.660 [0.455, 0.945]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.550 [0.440, 0.630]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e0.004\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCD3\u0026thinsp;+\u0026thinsp;T lymphocytes (cell/ul)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e504.000 [414.000, 785.500]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e589.000 [458.000, 806.000]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCD4\u0026thinsp;+\u0026thinsp;T lymphocytes (cell/ul)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e254.000 [222.500, 454.500]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e309.000 [152.000, 371.000]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCD8\u0026thinsp;+\u0026thinsp;T lymphocytes (cell/ul)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e220.000 [101.000, 305.500]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e240.000 [176.000, 395.000]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEBV in peripheral blood (%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e0.005\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNegative\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e15 (45.455)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e27 (75.000)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLatent infection\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e8 (24.242)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e8 (22.222)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eActive infection\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e10 (30.303)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1 (2.778)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePoor prognoses (%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.250\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eConsciousness disturbance\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e4 (10.256)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1 (2.041)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMechanical ventilation\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e3 (7.692)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e4 (8.163)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDeath\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1 (2.564)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0 (0.000)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"4\"\u003eThe EBV negative group showed relatively higher level of central nervous cryptococcus and TB (Mycobacterium tuberculosis) infections, but the prevalence of bacteria, viruses, autoimmune encephalitis antibodies (AE), and others pathogens were comparable.\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e\n\u003ch3\u003eClinical features between patients with or without EBV infection\u003c/h3\u003e\n\u003cp\u003eGenerally, there was no gender difference between the two groups, but patients in EBV-positive (EBV+) group were slightly older than EBV-negative (EBV-) group (Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eThere were several differences in clinical characteristics between the two groups. Firstly, immunosuppression was more common in the EBV\u0026thinsp;+\u0026thinsp;group compared to the EBV - group, particularly in cases of HIV infection and immunosuppression for non-neoplastic diseases. Secondly, significant differences were observed in CSF characteristics: the EBV\u0026thinsp;+\u0026thinsp;group had relatively higher cell counts and protein levels, while glucose and chloride levels were lower.\u003c/p\u003e \u003cp\u003eSignificant changes were also observed in peripheral blood. Compared to the EBV - group, the EBV\u0026thinsp;+\u0026thinsp;group exhibited significantly higher white blood cell counts and monocyte counts, while lymphocyte counts, as well as CD3+, CD4+, and CD8\u0026thinsp;+\u0026thinsp;T cell counts, showed an opposite trend. EBV in peripheral blood was tested in 213 patients (58 in the EBV\u0026thinsp;+\u0026thinsp;group and 155 in the EBV - group). The results showed that patients with CNS EBV infection were more likely to have active peripheral EBV infection. A total of 326 patients (89.6%) completed brain MRI scans. Although the EBV\u0026thinsp;+\u0026thinsp;group showed more meningeal involvement on MRI, there was no statistically significant difference observed (35.6% vs. 24.1%, \u003cem\u003ep\u003c/em\u003e\u0026gt;0.05) (Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eTo further explore the risk factors for CNS EBV infection, logistic regression was used to calculate ORs and 95% CIs. Immunosuppression, active peripheral EBV infection, and blood cells were analyzed after age and gender adjustment. The results showed that age, immunosuppression and active infection of peripheral EBV were independent risk factors for CNS EBV infection.\u003c/p\u003e \u003cp\u003ePathogens were determined in a total of 181 (49.8%) patients. The results showed that compared with the EBV - group, the EBV\u0026thinsp;+\u0026thinsp;group had relatively higher rates of cryptococcus and tuberculosis encephalitis, but viral and bacterial infections were similar between the two groups (Fig.\u0026nbsp;\u003cspan refid=\"Fig2\" class=\"InternalRef\"\u003e2\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003c/p\u003e\n\u003ch3\u003eComparison of clinical features in subgroups\u003c/h3\u003e\n\u003cp\u003eA comparison of clinical features among three groups: EBV-positive encephalitis, EBV-positive encephalitis of other etiology, and EBV-negative encephalitis, revealed significant differences. Specifically, EBV-negative encephalitis was characterized by significantly lower values in age, CSF white blood cell count, protein level, and peripheral blood monocyte count compared to both the EBV-positive encephalitis and EBV-positive encephalitis of other etiology groups. Concurrently, the EBV-positive encephalitis group exhibited notably higher levels of CSF glucose and chloride, as well as elevated counts of peripheral blood CD3+, CD4+, and CD8\u0026thinsp;+\u0026thinsp;T cells compared to the other two groups.\u003c/p\u003e \u003cp\u003eWhen comparing EBV-positive encephalitis to EBV-positive encephalitis of other etiology, the former group demonstrated significantly higher values in age, CSF glucose level, peripheral blood lymphocyte and monocyte counts, as well as CD3+, CD4+, and CD8\u0026thinsp;+\u0026thinsp;T cell levels. Conversely, they had lower values in CSF white blood cell count, protein level, chloride level, and peripheral blood white blood cell count.\u003c/p\u003e \u003cp\u003eRegarding the comparison between EBV-positive encephalitis of other etiology and EBV-negative encephalitis, additional differences were observed. Notably, the presence of immunosuppression, intrathecal IgG synthesis rate in CSF, and active infection of peripheral EBV were found to be higher in the EBV-positive encephalitis of other etiology group, alongside the previously mentioned disparities in clinical features.\u003c/p\u003e \u003cdiv id=\"Sec11\" class=\"Section2\"\u003e \u003ch2\u003eClinical features between EBV and other herpes viruses associated encephalitis\u003c/h2\u003e \u003cp\u003eA total of 39 patients were diagnosed with EBV-associated encephalitis among whom only EBV was detected and deemed as the pathogen. Another 49 cases were diagnosed with other herpesviruses-associated encephalitis (including 23 herpes simplex virus, 12 varicella-zoster virus, 2 cytomegalovirus, 1 human herpesvirus-6 and 11 human herpesvirus-7). Patients with EBV encephalitis tend to be older compared to those with encephalitis caused by other herpes viruses. In terms of CSF characteristics, patients with EBV encephalitis exhibit higher white blood cell counts and protein levels, while glucose and chloride levels are relatively lower. Compared to other herpes virus infections, individuals infected with EBV demonstrate higher peripheral blood white blood cell counts and monocyte counts, but lower lymphocyte, CD3+, CD4+, and CD8\u0026thinsp;+\u0026thinsp;T-cell counts. This observation is similar when comparing EBV\u0026thinsp;+\u0026thinsp;and EBV - groups. However, a notable difference is the higher incidence of meningeal involvement among patients with EBV encephalitis. Although the prognosis of EBV encephalitis is generally poor, the results of this study did not reveal a statistically significant difference (20.5% vs. 10.2%, \u003cem\u003ep\u003c/em\u003e\u0026gt;0.05) (Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e).\u003c/p\u003e \u003c/div\u003e"},{"header":"DISCUSSION","content":"\u003cp\u003eThe main findings of the study were as follows: 1) EBV could be found in CSF in approximately 24% of patients with acute encephalitis; 2) clinical characteristics of EBV-associated encephalitis differ from those of other herpes virus-associated encephalitis, specifically featuring leukocytosis and higher protein content, lower glucose and chloride levels in CSF, and more frequent meningeal involvement on MRI; and 3) age, immunosuppression and active peripheral EBV infection were independent risk factors for CNS EBV infection.\u003c/p\u003e \u003cp\u003eIn this retrospective cohort study, we found that EBV could be detected in CSF in nearly 24% of patients with confirmed acute encephalitis (including viral, tuberculous, bacterial, cryptococcal, and unknown cause). In line with our results, a previous study found that EBV exited the CSF of 26% of patients with bacterial meningitis using PCR.\u003csup\u003e20\u003c/sup\u003e Similar results from two studies with different populations and different techniques confirmed the commonness of EBV infection in acute encephalitis. Furthermore, we found that the rates of tuberculous and cryptococcal encephalitis were relatively higher in patients with CNS EBV infection, suggesting that CNS EBV may be associated with tuberculosis and cryptococcal infections, but the causal relationship deserves further research.\u003c/p\u003e \u003cp\u003eIn previous studies, glucose and chloride levels in CSF were often regarded as typical biomarkers for viral encephalitis. However, this study found that both EBV positive and negative encephalitis patients experienced varying degrees of reduction in CSF glucose and chloride levels. To eliminate interference from other pathogens such as cryptococcus and tuberculosis, we further excluded cases of related pathogen infections from the analysis, and the results still showed the presence of the aforementioned characteristics. To further investigate whether this phenomenon was limited to EBV-associated encephalitis, we selected 39 cases diagnosed with EBV-associated encephalitis from all 86 patients with EBV detected in their CSF and conducted a comparative analysis with another 49 cases of encephalitis caused by other herpes viruses. The results indicated that the decrease in glucose and chloride levels in the CSF of patients with EBV-associated encephalitis was more significant. This finding is consistent with reports in some case studies that showed reduced CSF glucose concentrations in patients with viral encephalitis.\u003csup\u003e21\u0026ndash;23\u003c/sup\u003e Currently, the mechanism underlying this phenomenon is not fully understood and may be related to multiple factors, including changes in blood-brain barrier function that limit glucose entry into the subarachnoid space, the rate of glucose transport through arachnoid villi, increased glycolysis in leukocytes and bacteria, and elevated metabolic rates in the central nervous system. This phenomenon suggests that subsequent changes in CSF glucose levels in viral encephalitis may be associated with the severity of the disease.\u003csup\u003e24\u003c/sup\u003e\u003c/p\u003e \u003cp\u003eFurthermore, this study found characteristics of leukocytosis and elevated protein levels in the CSF of patients with EBV-associated encephalitis, which is consistent with the findings of a previous retrospective analysis of 97 cases of EBV encephalitis.\u003csup\u003e25\u003c/sup\u003e It is worth noting that we also discovered that meningitis caused by the EB virus more commonly shows meningeal involvement on MRI. These manifestations further indicate that EB virus-associated encephalitis is a special type of encephalitis with characteristic presentations.\u003c/p\u003e \u003cp\u003eCurrently, the mechanism by which viruses cause encephalitis is not clear, but it is commonly believed that retrograde infection through the cranial nerve is the main pathway. However, the results of this study showed meningeal involvement on MRI in nearly 30% of patients with EBV-associated encephalitis, far higher than 6% in patients with other herpesviruses-associated encephalitis. These results suggest that destruction of the blood-brain barrier may be an important mechanism for CNS EBV infection. A major discovery in recent years is the lymphatic system in the brain, which connects the subarachnoid space, venous system, lymphatic vessels and deep cervical lymph nodes.\u003csup\u003e26\u0026ndash;28\u003c/sup\u003e We infer that EBV (a typical lymphotropic herpesviruses) may enter the CNS through these channels from the peripheral lymphatic and blood system.\u003c/p\u003e \u003cp\u003eSignificantly, EBV-associated encephalitis showed more common of immunosuppression and peripheral EBV infection. The results of logistic analyses also confirmed that immunosuppression and peripheral EBV infection were independent risk factors for CNS EBV infection, implying that EBV is an opportunistic infection in the CNS. Generally, EBV lurks in B lymphocytes in adults,\u003csup\u003e5, 20\u003c/sup\u003e and is controlled by a sustained immune response.\u003csup\u003e29\u003c/sup\u003e When the immune system is disrupted, EBV may proliferate extensively and invade the CNS. This hypothesis was supported by the results that patients with CNS EBV infection showed a relatively lower average value of CD3\u0026thinsp;+\u0026thinsp;and CD4\u0026thinsp;+\u0026thinsp;T lymphocytes than those without CNS EBV infection.\u003c/p\u003e \u003cp\u003eIt is noteworthy that this study found a general decrease in peripheral blood CD3+, CD4+, and CD8\u0026thinsp;+\u0026thinsp;T lymphocytes in patients with EBV encephalitis, suggesting a significant impact of EBV encephalitis on the immune system. Given the increasing understanding in recent years of the possibility of autoimmune encephalitis subsequent to herpes simplex encephalitis, and research indicating poor immune outcomes subsequent to EBV viral encephalitis.\u003csup\u003e14\u003c/sup\u003e It is essential to conduct relevant tests such as NMDA receptor antibody testing for patients with EBV encephalitis, if necessary, to provide a theoretical basis for combined immunotherapy.\u003csup\u003e30\u003c/sup\u003e\u003c/p\u003e \u003cdiv id=\"Sec13\" class=\"Section2\"\u003e \u003ch2\u003eLimitations\u003c/h2\u003e \u003cp\u003eFirst, due to the limitations of mNGS itself, we could not rule out the possibility of false positives or false negatives, but similar results from different analyses confirmed the robustness of the results. Second, some patients in our center were transferred from other regional hospitals, and many of them received antiviral treatment before arriving our center. Thus, the positive rate of EBV in untreated encephalitis patients may be higher than that reported here. Third, EBV can be detected in many patients with tuberculous, cryptococcal, or bacterial encephalitis, but the causal relationship between EBV and these pathogens needed to be explored in further studies. Finally, it is important to note that the data were collected during the COVID-19 pandemic, a period when lower circulating infections in society may have affected the prevalence of infections observed in our study. This potential limitation should be considered when interpreting the results.\u003c/p\u003e \u003c/div\u003e"},{"header":"CONCLUSIONS","content":"\u003cp\u003eOur results indicate that EBV infection is common and may be an opportunistic infection in patients with encephalitis, which may enter CNS mainly through the destruction of the blood-brain barrier. EBV-associated encephalitis is characterized by relatively reduced glucose and chloride levels, and more meningeal involvement on MRI than other herpesviruses-associated encephalitis.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eAuthor Contributions\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003econcept and design, Yongzhao Zhou. and Anjiao Peng; drafting of the manuscript and interpretation of data, Zhu Liu. and Luyan Huang; data acquisition, analysis, Yusha Tang; data analysis, Leihao Sha; critical revision of the manuscript for intellectual content; study supervision, Lei Chen. All authors have read and agreed to the published version of the manuscript.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eEthics approval and consent to participate\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis study has been approved by the Ethics Committee of West China Hospital, Sichuan University (No. 2022-857). Our data are extracted from the electronic medical record system and do not involve patient privacy, so a patient consent statement is not needed.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAvailability of data and materials\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe data supporting the findings of this study are available upon reasonable request from the corresponding author.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding statement\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis study was supported fund of West China Hospital of Sichuan University and University of Electronic Science and technology (No. HXDZ21006), and the National Natural Science Foundation of China (82201752).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting interests\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare no competing interests.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgments\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eGBD 2013 Mortality and Causes of Death Collaborators. Global, regional, and national age-sex specific all-cause and cause-specific mortality for 240 causes of death, 1990\u0026ndash;2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet. 2015 Jan 10;385(9963):117\u0026ndash;171.\u003c/li\u003e\n\u003cli\u003eMailles A, De Broucker T, Costanzo P, et al. Long-term outcome of patients presenting with acute infectious encephalitis of various causes in France. Clin Infect Dis. 2012 May;54(10):1455\u0026ndash;1464.\u003c/li\u003e\n\u003cli\u003eVenkatesan A. Epidemiology and outcomes of acute encephalitis. Curr Opin Neurol. 2015 Jun;28(3):277\u0026ndash;282.\u003c/li\u003e\n\u003cli\u003eTyler KL. Acute Viral Encephalitis. N Engl J Med. 2018 Aug 9;379(6):557\u0026ndash;566.\u003c/li\u003e\n\u003cli\u003eThorley-Lawson DA. EBV Persistence\u0026ndash;Introducing the Virus. Curr Top Microbiol Immunol. 2015;390(Pt 1):151\u0026ndash;209.\u003c/li\u003e\n\u003cli\u003eShannon-Lowe C, Rickinson A. The Global Landscape of EBV-Associated Tumors. Front Oncol. 2019 Aug 6;9:713.\u003c/li\u003e\n\u003cli\u003eZhang F, Zhang B, Ding H, et al. The Oxysterol Receptor EBI2 Links Innate and Adaptive Immunity to Limit IFN Response and Systemic Lupus Erythematosus. Adv Sci (Weinh). 2023 Sep;10(27):e2207108.\u003c/li\u003e\n\u003cli\u003eDebuysschere C, Nekoua MP, Hober D. Markers of Epstein-Barr Virus Infection in Patients with Multiple Sclerosis. Microorganisms. 2023 May 11;11(5):1262.\u003c/li\u003e\n\u003cli\u003eTsuruyama Y, Mori N, Yoshida S, et al. Epstein-Barr virus-related encephalitis in a young woman: A case report. J Infect Chemother. 2020 Jul;26(7):741\u0026ndash;744.\u003c/li\u003e\n\u003cli\u003eNakamura J, Yanagida M, Saito K, et al. Epstein-Barr virus encephalitis in a patient with rheumatoid arthritis. Mod Rheumatol Case Rep. 2022 Jun 24;6(2):160\u0026ndash;162.\u003c/li\u003e\n\u003cli\u003ePatnaik S, Samal P, Sahoo A, et al. A fulminant case of Epstein-Barr Virus encephalitis with multiorgan dysfunction. J Neurovirol. 2022 Jun;28(3):464\u0026ndash;466.\u003c/li\u003e\n\u003cli\u003eZhao H, Zhang X, Yang H, Gu J. Epstein-Barr virus encephalitis with excessive daytime sleepiness as the main manifestation: Two case reports. Medicine (Baltimore). 2022 Aug 26;101(34):e30327.\u003c/li\u003e\n\u003cli\u003eSchwenkenbecher P, Skripuletz T, Lange P, et al. Intrathecal Antibody Production Against Epstein-Barr, Herpes Simplex, and Other Neurotropic Viruses in Autoimmune Encephalitis. Neurol Neuroimmunol Neuroinflamm. 2021 Aug 24;8(6):e1062.\u003c/li\u003e\n\u003cli\u003eLiu D, Lin PH, Li HL, et al. Early autoimmunity and outcome in virus encephalitis: a retrospective study based on tissue-based assay. J Neurol Neurosurg Psychiatry. 2023 Aug;94(8):605\u0026ndash;613.\u003c/li\u003e\n\u003cli\u003eMcGill F, Griffiths MJ, Bonnett LJ, et al. UK Meningitis Study Investigators. Incidence, aetiology, and sequelae of viral meningitis in UK adults: a multicentre prospective observational cohort study. Lancet Infect Dis. 2018 Sep;18(9):992\u0026ndash;1003.\u003c/li\u003e\n\u003cli\u003eGuidelines for The Diagnosis, Prevention and Management of Cryptococcal Disease in HIV-Infected Adults, Adolescents and Children: Supplement to the 2016 Consolidated Guidelines on the Use of Antiretroviral Drugs for Treating and Preventing HIV Infection. Geneva: World Health Organization; 2018 Mar.\u003c/li\u003e\n\u003cli\u003eStott KE, Loyse A, Jarvis JN, et al. Cryptococcal meningoencephalitis: time for action. Lancet Infect Dis. 2021 Sep;21(9):e259-e271.\u003c/li\u003e\n\u003cli\u003eSchaller MA, Wicke F, Foerch C, Weidauer S. Central Nervous System Tuberculosis : Etiology, Clinical Manifestations and Neuroradiological Features. Clin Neuroradiol. 2019 Mar;29(1):3\u0026ndash;18.\u003c/li\u003e\n\u003cli\u003eSsebambulidde K, Bangdiwala AS, Kwizera R, et al. Symptomatic Cryptococcal Antigenemia Presenting as Early Cryptococcal Meningitis With Negative Cerebral Spinal Fluid Analysis. Clin Infect Dis. 2019 May 30;68(12):2094\u0026ndash;2098.\u003c/li\u003e\n\u003cli\u003eKelly MJ, Benjamin LA, Cartwright K, et al. Epstein-barr virus coinfection in cerebrospinal fluid is associated with increased mortality in Malawian adults with bacterial meningitis. J Infect Dis. 2012 Jan 1;205(1):106\u0026thinsp;\u0026minus;\u0026thinsp;10.\u003c/li\u003e\n\u003cli\u003eCao LJ, Zheng YM, Li F, et al. Varicella-zoster virus meningitis with hypoglycorrhachia: A case report. World J Clin Cases. 2023 Oct 16;11(29):7101\u0026ndash;7106.\u003c/li\u003e\n\u003cli\u003eFadhel M, Campbell N, Patel S, et al. Varicella Zoster Meningitis with Hypoglycorrhachia on Cerebrospinal Fluid (CSF) Analysis in a Young Immunocompetent Host without a Rash. Am J Case Rep. 2019 May 16;20:701\u0026ndash;704.\u003c/li\u003e\n\u003cli\u003eSpernovasilis N, Milioni A, Gialamas I,et al. Varicella-zoster virus meningitis with hypoglycorrhachia in a young immunocompetent adult without rash: A case report and literature review. IDCases. 2018 Apr 13;12:104\u0026ndash;106.\u003c/li\u003e\n\u003cli\u003eShrikanth V, Salazar L, Khoury N, et al. Hypoglycorrhachia in adults with community-acquired meningitis: etiologies and prognostic significance. Int J Infect Dis. 2015 Oct;39:39\u0026ndash;43.\u003c/li\u003e\n\u003cli\u003ePeuchmaur M, Voisin J, Vaillant M, et al. Epstein-Barr Virus Encephalitis: A Review of Case Reports from the Last 25 Years. Microorganisms. 2023 Nov 21;11(12):2825.\u003c/li\u003e\n\u003cli\u003eWei CJ, Yassine HM, McTamney PM, et al. Elicitation of broadly neutralizing influenza antibodies in animals with previous influenza exposure. Sci Transl Med. 2012 Aug 15;4(147):147ra114.\u003c/li\u003e\n\u003cli\u003eAspelund A, Antila S, Proulx ST, et al. A dural lymphatic vascular system that drains brain interstitial fluid and macromolecules. J Exp Med. 2015 Jun 29;212(7):991\u0026ndash;999.\u003c/li\u003e\n\u003cli\u003eLouveau A, Smirnov I, Keyes TJ, et al. Structural and functional features of central nervous system lymphatic vessels. Nature. 2015 Jul 16;523(7560):337\u0026ndash;341.\u003c/li\u003e\n\u003cli\u003eAfrasiabi A, Parnell GP, Fewings N, et al. Evidence from genome wide association studies implicates reduced control of Epstein-Barr virus infection in multiple sclerosis susceptibility. Genome Med. 2019 Apr 30;11(1):26.\u003c/li\u003e\n\u003cli\u003eVenkatesan A, Michael BD, Probasco JC, et al. Acute encephalitis in immunocompetent adults. Lancet. 2019 Feb 16;393(10172):702\u0026ndash;716.\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":true,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"virology-journal","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"virj","sideBox":"Learn more about [Virology Journal](http://virologyj.biomedcentral.com/)","snPcode":"12985","submissionUrl":"https://submission.nature.com/new-submission/12985/3","title":"Virology Journal","twitterHandle":"@VirologyJ","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"em","reportingPortfolio":"BMC/SO AJ","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"","lastPublishedDoi":"10.21203/rs.3.rs-5193534/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-5193534/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground\u003c/h2\u003e \u003cp\u003eEpstein-Barr virus (EBV) has been gradually recognized as an important pathogen of encephalitis, but our knowledge of EBV-associated encephalitis is still limited. The aim of this study was to describe the clinical features and explore the risk factors for EBV-associated encephalitis in a large cohort of Chinese patients.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e \u003cp\u003eAll patients with confirmed encephalitis in our center from June 2020 to April 2021 were enrolled. Data were extracted from the electronic medical record system and analyzed by Student's t test, Mann-Whitney U test, chi-square test, and logistic regression analyses.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e \u003cp\u003eThis study included a total of 364 patients diagnosed with encephalitis, among which 86 cases (23.6%) had EBV detected in their cerebrospinal fluid (CSF), and 39 cases were diagnosed with EBV-associated encephalitis. The clinical characteristics of EBV-associated encephalitis differ from those caused by other herpes viruses. Compared to other herpes virus-related encephalitis, patients with EBV encephalitis exhibited significantly higher protein levels (1.310 [0.695, 1.840] vs. 0.710 [0.490, 1.700], \u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.001), lower glucose levels (3.030 [2.585, 3.640] vs. 3.380 [2.990, 4.030], \u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.001), and a higher incidence of meningeal involvement on MRI (11 (30.6%) vs. 3 (6.5%), \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.010). Additionally, univariate logistic regression analysis revealed that age (OR\u0026thinsp;=\u0026thinsp;1.015, 95% CI: 1.002\u0026ndash;1.029), HIV infection (OR\u0026thinsp;=\u0026thinsp;4.285, 95% CI: 1.582\u0026ndash;11.816), non-tumor immunosuppression (OR\u0026thinsp;=\u0026thinsp;5.713, 95% CI: 1.588\u0026ndash;22.883), and peripheral blood EBV infection (OR\u0026thinsp;=\u0026thinsp;10.204, 95% CI: 4.231\u0026ndash;26.346) were independent risk factors for CNS EBV infection.\u003c/p\u003e\u003ch2\u003eConclusion\u003c/h2\u003e \u003cp\u003eCompared to other herpes virus-associated encephalitis, EBV encephalitis is characterized by a higher degree of meningeal involvement, elevated CSF protein levels, lower glucose levels, and a reduced T-lymphocyte count in peripheral blood. These characteristics suggest that EBV encephalitis may have a distinct pathophysiology.\u003c/p\u003e","manuscriptTitle":"Clinical features and risk factors for Epstein-Barr virus-associated encephalitis: a retrospective cohort study","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-04-21 05:33:31","doi":"10.21203/rs.3.rs-5193534/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Accepted","date":"2025-04-28T15:25:38+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-04-28T07:46:49+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"304168700940472261111153230858526488407","date":"2025-04-21T12:50:13+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2025-04-16T12:44:22+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2025-04-08T07:35:22+00:00","index":"","fulltext":""},{"type":"submitted","content":"Virology Journal","date":"2025-04-05T06:16:26+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"virology-journal","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"virj","sideBox":"Learn more about [Virology Journal](http://virologyj.biomedcentral.com/)","snPcode":"12985","submissionUrl":"https://submission.nature.com/new-submission/12985/3","title":"Virology Journal","twitterHandle":"@VirologyJ","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"em","reportingPortfolio":"BMC/SO AJ","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"9991d995-5e00-4acc-99e2-7063e1250786","owner":[],"postedDate":"April 21st, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"published-in-journal","subjectAreas":[],"tags":[],"updatedAt":"2025-05-19T16:02:10+00:00","versionOfRecord":{"articleIdentity":"rs-5193534","link":"https://doi.org/10.1186/s12985-025-02768-w","journal":{"identity":"virology-journal","isVorOnly":false,"title":"Virology Journal"},"publishedOn":"2025-05-13 15:57:54","publishedOnDateReadable":"May 13th, 2025"},"versionCreatedAt":"2025-04-21 05:33:31","video":"","vorDoi":"10.1186/s12985-025-02768-w","vorDoiUrl":"https://doi.org/10.1186/s12985-025-02768-w","workflowStages":[]},"version":"v1","identity":"rs-5193534","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-5193534","identity":"rs-5193534","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}