Encephalitis

Question 1

What is the most common viral cause of encephalitis?

Answer 1

HSV

Question 2

What are the viral causes of encephalitis?

Answer 2

HSV 1 + 2 
arboviruses
CMV
VZV
HV
Measles
Mumps 
rabies

Question 3

What are non-viral causes for encephalitis?

Answer 3

Any bacterial meningitis --> neisseria meningitidis, streptococcus pneumoniae
TB
Malaria
Listeria 
Lyme

Question 4

When would you always want to suspect encephalitis?

Answer 4

Decreased GCS
focal neurological lesions
seizures preceded by infection

Question 5

What are clinical features of encephalitis?

Answer 5

• bizarre encephalopathy behaviour or confusion
• decreased GCS or coma
• fever
• lethargy
• headache
• focal neurological signs
• seizues
• Hx travel or animal bite

Question 6

What investigations are done for encephalitis?

Answer 6

Bloods: 
• blood cultures
• serum for viral PCR 
•throat swab
•MSU
•FBC - predominantly lymphocytes 
Contrast:
•enhanced CT
LP
•typically moderate increase protein in CSF

Question 7

What is the management of encephalitis?

Answer 7

Acyclovir - need 14 days empirical treatment
Supportive
Symptomatic –> phenytoin for seizures

Question 8

What is the mortality rate when no treatment?

Answer 8

70%