Encephalitis

Revisión del 02:46 13 ene 2015 de Arsmd (discusión | contribs.) (citation)

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

  1. New psychiatric symptoms (HSV)[1]
  2. Cognitive deficits
    1. Aphasia, amnesia, confusion
  3. Seizure
  4. Movement disorder (arboviruses)
  5. Fever and meningeal signs are almost always present

Diagnosis

  1. CT Head
    1. Medial temporal and inf frontal grey matter c/w HSV
  2. LP
    1. Bloody tap c/w HSV

DDX

  1. Meningitis
  2. SAH
  3. Lyme disease
  4. Brain abscess
  5. Bacterial endocarditis
  6. Toxic / metabolic encephalopathy

Treatment

  1. HSV encephalitis
    1. Acyclovir 10mg/kg q8hr
  2. HZV encephalitis
    1. Acyclovir 10mg/kg q8hr
  3. CMV encephalitis
    1. Ganciclovir 5mg/kg IV q12hr

Disposition

  1. 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.
  1. ↑ 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.
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