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Encephalitis diagnosis and management in the real world
Journal article   Peer reviewed

Encephalitis diagnosis and management in the real world

Sarah S Long
Advances in experimental medicine and biology, v 697
2011
PMID: 21120725

Abstract

Acute Disease Anti-Bacterial Agents - therapeutic use Antiviral Agents - therapeutic use Child Encephalitis - diagnosis Encephalitis - drug therapy Encephalitis - prevention & control Humans Immunosuppressive Agents - therapeutic use
Significant advances, especially in microbiologic diagnostics and brain imaging, have broadened our understanding of the etiology, pathogenesis, and natural history of acute encephalitis. In some instances this had led to specific therapies and preventive measures. The clinical hallmark of acute encephalitis is the triad of fever, headache, and altered mental status. Common neurologic features include disorientation or depressed level of consciousness; disturbances of behavior, speech, or executive function; and diffuse or focal neurologic signs such as cranial nerve dysfunction, hemiparesis, or seizures. These features distinguish the unusual patient with encephalitis from the more commonly encountered patient with uncomplicated meningitis who has fever, headache, and nuchal rigidity but lacks abnormal global or focal neurologic signs. Etiologies of acute encephalitis are myriad. Most are viral infections. Table 1 shows a robust but not exhaustive list of viral etiologies. Beyond this there is another robust but not exhaustive list (Table 2) of important considerations in the differential diagnosis. These include infectious agents (bacterial, fungal, parasitic, and amebic) as well as non-infectious etiologies (parainfectious, post-infectious, autoimmune, neoplastic, cerebrovascular, systemic, and other conditions). The challenge for the clinician is to rapidly hone the list and make critical management decisions by considering the specific features of the setting of the patient's illness, host susceptibility, clinical and neurologic findings, and results of laboratory and imaging studies.

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Web of Science research areas
Biology
Immunology
Infectious Diseases
Medicine, Research & Experimental
Pediatrics
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