Herpes simplex encephalitis: Difference between revisions
From IDWiki
m (Aidan moved page DNA Herpes simplex encephalitis to Herpes simplex encephalitis without leaving a redirect) |
mNo edit summary |
||
| Line 1: | Line 1: | ||
| + | * Infection of the brain parenchyma by [[Herpes simplex virus|HSV]], with a predilection for temporal lobes |
||
| − | = Herpes simplex encephalitis = |
||
| − | + | = Presentation = |
|
* Fever |
* Fever |
||
| Line 11: | Line 11: | ||
* Rapidly progressing and can lead to coma |
* Rapidly progressing and can lead to coma |
||
| − | + | = Investigations = |
|
* Imaging |
* Imaging |
||
| Line 27: | Line 27: | ||
** Usually predominately over involved termporal lobe |
** Usually predominately over involved termporal lobe |
||
| − | + | = Management = |
|
* Acyclovir 10mg/kg q8h IV for 14 days |
* Acyclovir 10mg/kg q8h IV for 14 days |
||
** Adjust for renal function |
** Adjust for renal function |
||
| + | |||
| + | [[Category:HSV]] |
||
| + | [[Category:CNS infections]] |
||
Revision as of 16:10, 13 August 2019
- Infection of the brain parenchyma by HSV, with a predilection for temporal lobes
Presentation
- Fever
- Headache
- Altered level of consciousness
- Personality and behavioural changes
- Focal neuro deficits
- Seizures
- Rapidly progressing and can lead to coma
Investigations
- Imaging
- CT head usually normal
- MRI head can show T2 signal change in temporal lobes
- Lumbar puncture
- Elevated protein
- Lymphocytosis (10-1000 WBCs)
- Erythrocytes in 80% of cases ("hemorrhagic necrotizing meningoencephalitis")
- Normal or slightly low glucose
- HSV PCR is confirmatory
- EEG
- Spikes and slow waves over involved areas
- Periodic lateralized epiieptiform discharges (PLEDs)
- Usually predominately over involved termporal lobe
Management
- Acyclovir 10mg/kg q8h IV for 14 days
- Adjust for renal function
