Diferencia entre revisiones de «Encephalitis»
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==Treatment== | ==Treatment== | ||
===[[HSV]] encephalitis=== | |||
#[[Acyclovir]] 10mg/kg every 8hrs | |||
===[[HZV]] encephalitis=== | |||
#[[Acyclovir]] 10mg/kg every 8hr | |||
===[[CMV]] encephalitis | |||
#Ganciclovir 5mg/kg IV every 12hr OR | |||
#Foscarnet 90mg/kg IV every 12 hrs | |||
==Disposition== | ==Disposition== | ||
Revisión del 20:12 6 abr 2015
Background
- Infection of brain parenchyma of the temporal lobes and inferior frontal lobe causing distinct neurologic abnormality
- Pathophysiology
- Gray matter is predominantly affected (cognitive / psychiatric signs, lethargy, seizure)
Microbiology
Clinical Features
- New psychiatric symptoms (HSV)[1]
- Cognitive deficits
- Aphasia, amnesia, confusion
- Seizure
- Movement disorder (arboviruses)
- Fever and meningeal signs are almost always present
Diagnosis
- CT Head
- Medial temporal and inf frontal grey matter c/w HSV
- LP
- Bloody tap c/w HSV
DDX
- Meningitis
- SAH
- Lyme disease
- Brain abscess
- Bacterial endocarditis
- Toxic / metabolic encephalopathy
Treatment
HSV encephalitis
- Acyclovir 10mg/kg every 8hrs
HZV encephalitis
- Acyclovir 10mg/kg every 8hr
===CMV encephalitis
- Ganciclovir 5mg/kg IV every 12hr OR
- Foscarnet 90mg/kg IV every 12 hrs
Disposition
- Admit
Source
- Tintinalli
- Loring KE, Tintinalli JE: Central Nervous System and Spinal Infections, in Tintinalli JE, Kelen GD, Stapczynski JS (eds): Emergency Medicine, A Comprehensive Study Guide, ed 7. New York, McGraw-Hill, 2011, (Ch) 168:p 1175-1176.
- ↑ Loring KE, Tintinalli JE: Central Nervous System and Spinal Infections, in Tintinalli JE, Kelen GD, Stapczynski JS (eds): Emergency Medicine, A Comprehensive Study Guide, ed 7. New York, McGraw-Hill, 2011, (Ch) 168:p 1175-1176.