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)
  • 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