Encephalitis: Difference between revisions
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***[[Herpes simplex encephalitis|Herpes simplex virus]] |
***[[Herpes simplex encephalitis|Herpes simplex virus]] |
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***[[Varicella-zoster virus]] |
***[[Varicella-zoster virus]] |
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− | ***[[Enteroviruses]] |
+ | ***[[Enterovirus|Enteroviruses]] |
− | ***[[Eastern equine encephalitis|Eastern]] or [[Western equine encephalitis]], [[Japanese encephalitis]], [[Murray Valley encephalitis]], [[St. Louis encephalitis]], [[West Nile virus]] |
+ | ***[[Eastern equine encephalitis virus|Eastern]] or [[Western equine encephalitis virus]], [[Japanese encephalitis virus]], [[Murray Valley encephalitis virus]], [[St. Louis encephalitis virus]], [[West Nile virus]] |
***[[Rabies virus]] |
***[[Rabies virus]] |
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***[[Hendra virus]] |
***[[Hendra virus]] |
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***[[Nipah virus]] |
***[[Nipah virus]] |
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− | ***[[Tickborne encephalitis]], [[La Crosse virus]], [[Powassan virus]] |
+ | ***[[Tickborne encephalitis virus]], [[La Crosse virus]], [[Powassan virus]] |
**Bacteria |
**Bacteria |
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***''[[Mycoplasma pneumoniae]]'' |
***''[[Mycoplasma pneumoniae]]'' |
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|space-occupying lesions |
|space-occupying lesions |
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− | |[[Toxoplasma gondii]], [[Balamuthia mandrillaris]], [[Acanthamoeba |
+ | |[[Toxoplasma gondii]], [[Balamuthia mandrillaris]], [[Acanthamoeba]], [[Taenia solium]] |
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|subependymal enhancement |
|subependymal enhancement |
Latest revision as of 12:46, 25 January 2022
- Infection of the brain parenchyma causing clouding of the sensorium
- Some overlap with meningitis
Differential Diagnosis
- Common causes include HSV, VZV, and enterovirus in developed countries
- Consider rabies virus, Japanese encephalitis virus, West Nile virus, tickborne encephalitis virus, and St. Louis encephalitis virus depending on travel history
- Infectious
- Viruses
- Herpes simplex virus
- Varicella-zoster virus
- Enteroviruses
- Eastern or Western equine encephalitis virus, Japanese encephalitis virus, Murray Valley encephalitis virus, St. Louis encephalitis virus, West Nile virus
- Rabies virus
- Hendra virus
- Nipah virus
- Tickborne encephalitis virus, La Crosse virus, Powassan virus
- Bacteria
- Other
- Viruses
- Non-infectious (including post-infectious)
- Cryptogenic in 50-70%
Investigations
- Lumbar puncture for viral culture or PCR
- MRI is the best neuroimaging; CT if MRI not available
- EEG is rarely helpful except to rule out non-convulsive status epilepticus
MRI
Management
- Empiric acyclovir 10 mg/kg IV q8h for suspected HSV or VZV encephalitis
- Add doxycycline if rickettsiosis or ehrlichiosis is possible