Encephalitis: Difference between revisions

Revision as of 22:32, 15 September 2019

Infection of the brain parenchyma causing clouding of the sensorium
Some overlap with meningitis

Differential Diagnosis

Infectious
- Viruses
- Bacteria
  - Mycoplasma pneumoniae
  - Listeria monocytogenes
  - Borrelia burgdorferi (Lyme disease)
  - Coxiella burnetii
  - Bartonella henselae or B. quintana
- Other
  - Cryptococcus neoformans
  - Toxoplasma gondii
  - Bayliscarias procyonis
  - Prion disease (CJD)
Non-infectious (including post-infectious)
- Acute disseminated encephalomyelitis (ADEM)
- Vasculitis
- Collagen vascular disorders
- Paraneoplastic syndromes

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

Management

Acyclovir for suspected HSV or VZV encephalitis

@@ Line 1: / Line 1: @@
 * Infection of the brain parenchyma causing clouding of the sensorium
-* Some overlap with [[Meningitis|meningitis]]
+* Some overlap with [[meningitis]]
-= Differential Diagnosis =
+== Differential Diagnosis ==
 * Infectious
 ** Viruses
-*** Enteroviruses
+*** [[Enteroviruses]]
-*** Eastern or Western equine encephalitis, Japanese encephalitis, Murray Valley encephalitis, St. Louis encephalitis, West Nile virus
+*** [[Eastern equine encephalitis|Eastern]] or [[Western equine encephalitis]], [[Japanese encephalitis]], [[Murray Valley encephalitis]], [[St. Louis encephalitis]], [[West Nile virus]]
-*** Rabies
+*** [[Rabies virus]]
-*** Hendra virus
+*** [[Hendra virus]]
-*** Nipah virus
+*** [[Nipah virus]]
-*** Tickborne encephalitis, La Crosse virus, Powassan virus
+*** [[Tickborne encephalitis]], [[La Crosse virus]], [[Powassan virus]]
 ** Bacteria
-*** ''Mycoplasma pneumoniae''
+*** ''[[Mycoplasma pneumoniae]]''
-*** ''Listeria monocytogenes''
+*** ''[[Listeria monocytogenes]]''
-*** ''Borrelia burgdorferi'' (Lyme disease)
+*** ''[[Borrelia burgdorferi]]'' (Lyme disease)
-*** ''Coxiella burnetii''
+*** ''[[Coxiella burnetii]]''
-*** ''Bartonella henselae'' or ''B. quintana''
+*** ''[[Bartonella henselae]]'' or ''[[B. quintana]]''
 ** Other
-*** ''Cryptococcus neoformans''
+*** ''[[Cryptococcus neoformans]]''
-*** ''Toxoplasma gondii''
+*** ''[[Toxoplasma gondii]]''
-*** ''Bayliscarias procyonis''
+*** ''[[Bayliscarias procyonis]]''
-*** Prion disease (CJD)
+*** Prion disease ([[CJD]])
 * Non-infectious (including post-infectious)
 ** Acute disseminated encephalomyelitis (ADEM)
@@ Line 29: / Line 29: @@
 ** Paraneoplastic syndromes
-= Investigations =
+== Investigations ==
 * Lumbar puncture for viral culture or PCR
@@ Line 35: / Line 35: @@
 * EEG is rarely helpful except to rule out non-convulsive status epilepticus
-= Management =
+== Management ==
-* Acyclovir for syspected HSV or VZV encephalitis
+* Acyclovir for suspected HSV or VZV encephalitis
 [[Category:CNS infections]]