Clinical, Radiological, Immunological and Genetic profile of Patients with Encephalitis in a Latin American Tertiary Centre: A Pilot Study
Latin America, and Brazil in particular, face unique challenges. Our region is marked by a wide range of infections—such as dengue, Zika, and chikungunya—as well as a highly mixed genetic background. These factors make encephalitis more complex and under-researched in our setting. Furthermore, in Brazil, many children experience significant delays before reaching tertiary centers. This late referral often means they arrive with advanced disease, complicating both diagnosis and treatment, and underscoring the urgent need for earlier recognition and standardized care.
This project will study children admitted with suspected encephalitis at the Hospital das Clínicas, the largest tertiary center in Latin America. We will collect clinical data, laboratory tests, brain imaging (MRI with spectroscopy), electroencephalograms, and cerebrospinal fluid (CSF). Blood and CSF samples will be analyzed for inflammatory molecules (cytokines), autoimmune antibodies, and hidden infections using metagenomic sequencing. For cases that remain unexplained, we will perform whole exome sequencing to investigate possible genetic conditions linked to encephalitis.
By integrating clinical, radiological, immunological, and molecular approaches, this pilot study aims to increase the proportion of patients with a definitive diagnosis. The results will provide a foundation for larger multicenter studies in Brazil and Latin America, foster collaborations, and support the development of institutional protocols for encephalitis management. Ultimately, our goal is to improve early diagnosis, guide treatment strategies, and enhance long-term outcomes for children and families facing this devastating condition.
Dr Larissa Baccoli de Souza
My name is Larissa Baccoli de Souza, I completed a two-year fellowship in Paediatric Neurology at Hospital das Clínicas (HC-FMUSP) in February 2025. I am currently based at the Instituto da Criança (ICr-HC-FMUSP), a leading tertiary paediatric referral centre in Brazil and Latin America, which provides highly specialised care for children with complex neurological and systemic conditions. Upon finishing my training, I continued as a Volunteer Paediatric Neurologist at the Neuroimmunology Outpatient Clinic under the supervision of Dr Renata Paolilo. This clinical and academic role has provided me with direct exposure to the evaluation and management of complex neuroimmunological disorders, including autoimmune encephalitis and central nervous system demyelinating diseases.
As part of my academic activities, I have also participated as a speaker at the Brazilian Congress of Paediatric Neurology, alongside my mentor Dr Renata Paolilo and Dr Ming Lim (London), in a dedicated session focused on the discussion of complex neuroimmunological cases in the paediatric population. In October 2024, I completed an international observership at the Paediatric Neuroimmunology Service of Hospital Garrahan in Buenos Aires, Argentina, under the mentorship of Dr Silvia Tenembaum, a recognized leader in paediatric demyelinating and autoimmune disorders. This opportunity strengthened my expertise in diagnostic approaches, clinical monitoring, and therapeutic strategies for children with autoimmune encephalitis and related conditions.
In addition, I have participated as co-investigator in multicenter studies on multiple sclerosis, neuromyelitis optica spectrum disorder, and myasthenia gravis, expanding my research experience in neuroimmunology. I am also involved in projects investigating the relationship between immune-mediated diseases and COVID-19, as well as a retrospective study on encephalitis conducted at our center. These activities have consolidated my interest in developing research focused on encephalitis in Latin America, with emphasis on integrative approaches that combine clinical, radiological, immunological, and molecular analyses.
