Diferencia entre revisiones de «Encephalitis»
Sin resumen de edición |
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| Línea 1: | Línea 1: | ||
==Background== | ==Background== | ||
*Infection of brain parenchyma causing distinct neurologic abnormality | *Infection of brain parenchyma causing distinct neurologic abnormality | ||
*Pathophysiology | *Pathophysiology | ||
**Gray matter is predominantly affected (cognitive / psychiatric signs, lethargy, seizure) | **Gray matter is predominantly affected (cognitive / psychiatric signs, lethargy, seizure) | ||
===Microbiology=== | |||
*[[HSV]] | |||
*[[HZV]] | |||
*[[EBV]] | |||
*[[CMV]] | |||
*[[Rabies]] | |||
*Arboviruses ([[West Nile]], St. Louis equine) | |||
==Clinical Features== | ==Clinical Features== | ||
| Línea 10: | Línea 16: | ||
#Cognitive deficits | #Cognitive deficits | ||
##Aphasia, amnesia, confusion | ##Aphasia, amnesia, confusion | ||
#Seizure | #[[Seizure]] | ||
#Movement disorder (arboviruses) | #Movement disorder (arboviruses) | ||
#Fever and meningeal signs are almost always present | #[[Fever]] and meningeal signs are almost always present | ||
==Diagnosis== | ==Diagnosis== | ||
#CT Head | #CT Head | ||
##Medial temporal and inf frontal grey matter c/w HSV | ##Medial temporal and inf frontal grey matter c/w HSV | ||
#LP | #[[LP]] | ||
##Bloody tap c/w HSV | ##Bloody tap c/w HSV | ||
==DDX== | ==DDX== | ||
#Meningitis | #[[Meningitis]] | ||
#SAH | #[[SAH]] | ||
#Lyme disease | #[[Lyme disease]] | ||
#Brain abscess | #Brain abscess | ||
#Bacterial endocarditis | #Bacterial [[endocarditis]] | ||
#Toxic / metabolic encephalopathy | #Toxic / metabolic encephalopathy | ||
==Treatment== | ==Treatment== | ||
#HSV encephalitis | #HSV encephalitis | ||
##Acyclovir 10mg/kg q8hr | ##[[Acyclovir]] 10mg/kg q8hr | ||
#HZV encephalitis | #HZV encephalitis | ||
##Acyclovir 10mg/kg q8hr | ##[[Acyclovir]] 10mg/kg q8hr | ||
#CMV encephalitis | #CMV encephalitis | ||
##Ganciclovir 5mg/kg IV q12hr | ##Ganciclovir 5mg/kg IV q12hr | ||
Revisión del 18:04 21 sep 2014
Background
- Infection of brain parenchyma causing distinct neurologic abnormality
- Pathophysiology
- Gray matter is predominantly affected (cognitive / psychiatric signs, lethargy, seizure)
Microbiology
Clinical Features
- New psychiatric symptoms (HSV)
- 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 q8hr
- HZV encephalitis
- Acyclovir 10mg/kg q8hr
- CMV encephalitis
- Ganciclovir 5mg/kg IV q12hr
Disposition
- Admit
Source
Tintinalli