Encephalitis: Difference between revisions
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==Background== | ==Background== | ||
*Infection of brain parenchyma causing distinct neurologic abnormality | *Infection of brain parenchyma of the temporal lobes and inferior frontal lobe 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) | ||
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==Clinical Features== | ==Clinical Features== | ||
#New psychiatric symptoms (HSV) | #New psychiatric symptoms (HSV)<ref>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.</ref> | ||
#Cognitive deficits | #Cognitive deficits | ||
##Aphasia, amnesia, confusion | ##Aphasia, amnesia, confusion | ||
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==Source== | ==Source== | ||
Tintinalli | *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. | |||
[[Category:Neuro]] | [[Category:Neuro]] | ||
Revision as of 02:46, 13 January 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 q8hr
- HZV encephalitis
- Acyclovir 10mg/kg q8hr
- CMV encephalitis
- Ganciclovir 5mg/kg IV q12hr
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.