Encephalitis

Question 1

What is encephalitis and cause?

Answer 1

Inflammation of the brain parenchyma as opposed to the meninges in meningitis

Cause:
* HSV- most common cause
* Varicella zoster virus
* Measles, mumps and rubella
* Virsues spread by animals

Question 2

Investigations in suspected encephalitis?

Answer 2

FBC- to exclude neutropenia/lymphopenia
U&E, FLTs- some infections cause deranged kidney and liver function
Blood culutres
Throat swab- for viral PCR
CT brain- screening
MRI brain
EEG- seizures
CSF analysis- cells, cultire, protein, glucose and viral PCR
HIV test- in all cases for suspected CNS infection

Question 3

CSF findings in encephalitis?

Answer 3

WCC- lymphocytic- raised
Glucose- normal/low
Opening pressure- normal
Proteins- normal

Question 4

Management of encephalitis?

Answer 4

Supportive measures
In immunocompromised patients- 1st line- IV aciclovir