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Viral Meningitis and Encephaliti1

Viral Meningitis and Encephaliti1 - include source • The...

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Viral Meningitis and Encephalitis 1.4. Diagnosis Presence of HSV DNA in CSF detected by PCR is best means to make a diagnosis of HSV encephalitis. Arboviral infection detected by serum antibody of CSF, culture of CSF or serum antibody. Enteroviruses can be cultured from CSF, stool, and throat wash. 1.5. Differential Diagnosis The differential diagnosis requires the exclusion of tumors, vascular malformations, a fungal or tuberculous process, toxoplasmosis, brain abscess, bacterial meningitis with an encephalitic component, Lyme disease, syphilis, or lead intoxication. 1.6. Prognosis In contrast to aseptic meningitis the morbidity and mortality for encephalitis is considerable. The prognosis depends somewhat on the specific causative agent. For example, the overall mortality for arboviral encephalitis in the United States between 1955 and 1971 was 50% for Eastern Equine Encephalitis (EEE), 8% for St. Louis Encephalitis (SLE), 2.9% for Western Equine (WE) and 0.4% for California (CE).
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Unformatted text preview: include source? • The mortality for untreated Herpes simplex encephalitis is 70%.With current therapy, , the mortality can be reduced to about 15-20% but there may be considerable morbidity with long term neurologic sequelae, especially if the onset of treatment is delayed. • In children with WEE who were < 1 year of age at the onset of infection, 57% developed either mental retardation, paralysis, seizures, spasticity, speech difficulties, hearing defects. • The most treatable form of viral encephalitis is Herpes simplex. • There has been the introduction of a new course of viral encephalitis into US from Middle East-West Nile Encephalitis. It is a flavivious like St. Louis Encephalitis, Japanese Encephalitis and Dengue. Clinical manifestations similar to other viral encephalitides except profound weakness, lower motor neuron symptoms common. Most severe illness in elderly. Expanding pool of virus activity throughout US over 90 deaths last year....
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