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Viral EncephalitisAka: Encephalitis

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  1. Cause
    1. Common
      1. Herpes Simplex encephalitis (Very poor prognosis)
        1. Adults: Herpes Simplex Virus I
        2. Neonates: Herpes Simplex Virus II
      2. Arbovirus
        1. Eastern equine encephalitis (70-90% poor prognosis)
        2. Western equine encephalitis (2-20% poor prognosis)
        3. St. Louis encephalitis (2-20% poor prognosis)
        4. California encephalitis (generally benign)
        5. Venezuelan equine encephalitis (generally benign)
        6. West Nile Virus Encephalitis (severe in elderly)
      3. Mumps (Generally benign)
    2. Uncommon
      1. Enterovirus
      2. Varicella Zoster Virus
      3. Epstein-Barr Virus
      4. Mycoplasma
      5. Rabies (rare in U.S.)
    3. Immunocompromised
      1. Cytomegalovirus (AIDS)
  2. Symptoms
    1. Sudden high fever
    2. Severe Headache
    3. Meningismus
    4. Stiff neck
    5. Depressed mental status
      1. Lethargy
      2. Mental confusion
      3. Coma
    6. Behavior change
    7. Seizure
    8. Dysarthria
    9. Nausea and Vomiting
  3. Signs
    1. Variable signs depending on involvement and organism
    2. Tremor
      1. Tongue
      2. Lips
      3. Hands
    3. Ataxia
    4. Spastic paralysis
    5. Deep Tendon Reflexes exaggerated
  4. Labs
    1. Complete Blood Count (CBC)
      1. Mild Leukocytosis
      2. Mild Lymphocytosis
    2. Cerebrospinal Fluid (CSF)
      1. Increased Intracranial Pressure
      2. Increased Protein
      3. Lymphocytic Pleocytosis
  5. Management
    1. Cerebral Edema
      1. Mannitol
      2. Corticosteroids
        1. Only for specific indications
        2. Avoid in Herpes Simplex Virus
    2. Seizure control
    3. Keep high level of suspicion for treatable etiologies
      1. HSV Encephalitis: Acyclovir IV
      2. CMV Encephalitis (AIDS): Ganciclovir or Foscarnet
  6. Course
    1. Symptomatic: weeks to months
  7. Prognosis
    1. Mortality during acute illness: 10%
    2. High rate of Disability following infection
      1. Variable depending on specific etiology
  8. Resources: Patients
    1. Encephalitis Global Support Website
      1. http://communities.msn.com/encephalitisglobal

Encephalitis (C0014038)

Definition (MSH)Inflammation of the BRAIN due to infection, autoimmune processes, toxins, and other conditions. Viral infections (see ENCEPHALITIS, VIRAL) are a relatively frequent cause of this condition.
Definition (CSP)inflammation of the brain due to infection, autoimmune processes, toxins, and other conditions; viral infections are a relatively frequent cause of this condition.
ConceptsDisease or Syndrome (T047)
ICD9V12.42
EnglishBRAIN INFLAMM, Brain Inflammation, Brain Inflammations, ENCEPH, Encephalitis, INFLAMM BRAIN
Spanishencefalitis
CreditsDerived from the NIH UMLS (Unified Medical Language System)



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