Viral Encephalitis

Definition

• Viral infection of the brain parenchyma

Etiologies (Lance* 2002:359:507; Neuiotefy 2006:6675)

• Arboviruses ( 9%): Eastern equine,Western equine. West Nile. Sl Louis

• Enteroviruses: Coxsackie. echo

• Others:VZV ( 9%). CMV. EBV. HIV. rabies, adenoviruses

• Nonviral etiologies that mimic: bacterial endocarditis, abscess, toxoplasmosis.TB.

toxins, vasculitis, subdural hematoma

Clinical manifestations

• Fever, HA. a MS. • seizures and focal neuro findings (latter atypical for viral meningitis) Diagnostic studies

• Lumbar puncture: lymphocytic pleocytosis; PCRs available for HSV.VZV. CMV. adeno, enterovirus in right setting. ELISA or DFA of nasal or resp swabs for adenovirus or flu Ags serologies

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