Encephalitis: Difference between revisions
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Revision as of 13:31, 12 August 2019
Encephalitis
Definition
- Infection of the brain parenchyma causing clouding of the sensorium
- Some overlap with meningitis
Differential Diagnosis
- Infectious
- Viruses
- Enteroviruses
- Eastern or Western equine encephalitis, Japanese encephalitis, Murray Valley encephalitis, St. Louis encephalitis, West Nile virus
- Rabies
- Hendra virus
- Nipah virus
- Tickborne encephalitis, La Crosse virus, Powassan virus
- 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)
- Viruses
- 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 syspected HSV or VZV encephalitis