Presentation
The authors will publish findings from this review in a peer-reviewed scientific journal (electronic and in-print) and present the results at national and international conferences. TRIAL REGISTRATION NUMBER: CRD42015029217. [ncbi.nlm.nih.gov]
Entire Body System
-
Hunting
PubMed Hunt G. Meningitis and encephalitis in adolescents. Adolesc Med State Art Rev. 2010; 21(2): 287-317, ix-x. PubMed Lindquist L, Vapalahti O. Tick-borne encephalitis. Lancet. 2008; 371(9627): 1861-71. PubMed Long SS. [arupconsult.com]
McGlasson S, July A, Jackson A, Hunt D. Type I interferon dysregulation and neurological disease. Nat Rev Neurol 2015;11:515–23 pmid:26303851 View Article PubMed/NCBI Google Scholar 51. [journals.plos.org]
-
Hypothermia
To identify infectious etiologies of encephalitis in Thailand, we conducted surveillance in 7 hospitals during July 2003–August 2005 and selected patients with acute onset of brain dysfunction with fever or hypothermia and with abnormalities seen on neuroimages [wwwnc.cdc.gov]
Psychiatrical
-
Suggestibility
RESULTS: Fourteen of the 25 antibodies tested showed binding to Western blots of human nervous tissue, suggesting the presence of shared epitopes. [ncbi.nlm.nih.gov]
Louis encephalitis virus infection, suggesting that neurologic illness from flaviviruses may also be seen in the post-infectious period following mild clinical illness. Received April 9, 2004. Accepted June 24, 2004. [neurology.org]
[…] within the 72 h before or after presentation - Generalized or partial seizures not fully attributable to a pre-existing seizure disorder - New onset of focal neurologic findings - CSF WBC count 5/cubic mm - Abnormality of brain parenchyma on neuroimaging suggestive [clinmedjournals.org]
-
Psychiatric Symptoms
The two patients with NMDAR-Abs presented neurological and psychiatric symptoms typical of NMDAR-Abs encephalitis. CONCLUSIONS: Autoimmune etiology seems to be rare (less than 2%) in patients with acute febrile encephalitis. [ncbi.nlm.nih.gov]
Movement disorders, psychiatric symptoms, agitation, speech dysfunction, cerebrospinal fluid oligoclonal bands, MRI limbic encephalitis, and clinical relapse were more common in patients with autoantibodies. [pediatrics.aappublications.org]
Workup
Should there be a standardised approach to the diagnostic workup of suspected adult encephalitis? A case series from Australia. BMC Infect Dis. 2010 Dec 15;10:353. PMC3018438. Irani SR, Vincent A. [lifeinthefastlane.com]
Finding the causative agent in infectious encephalitis is a daunting task; despite extensive diagnostic workup 1/3 to 2/3 of the cases have an unknown etiology by the time of admission to rehabilitation. 1 Etiological agents differ between immunocompetent [now.aapmr.org]
Microbiology
-
Listeria Monocytogenes
Bacteria can also be incriminated: Mycobacterium tuberculosis and Listeria monocytogenes are the most frequent, after HSV and VZV, in a French prospective study. The epidemiology of encephalitis is constantly evolving. [ncbi.nlm.nih.gov]
Causative agents were identified in 52% of cases in the study, and 38% in PMSI ( P Listeria monocytogenes and Mycobacterium tuberculosis were less frequent in PMSI than in the study ( Listeria : 2% vs. 5%, P 0·001; Mycobacterium : 2% vs. 8%, P Listeria [cambridge.org]
Nonviral causes can include bacteria (including Borrelia burgdorferi, Coxiella burnetii, Rickettsia rickettsii, Erlichia chaffeensis, Listeria monocytogenes, Mycobacterium tuberculosis) as well as parasites (Toxoplasma gondii, Trypanosoma brucei, Plasmodium [infectiousdiseaseadvisor.com]
-
Borrelia Burgdorferi
METHODS: Binding of 25 antibodies against 17 neurotropic pathogens comprising Borrelia burgdorferi, Toxoplasma gondii, and various DNA and RNA viruses to Western blots of human cortex and myelin from central and peripheral nervous system was investigated [ncbi.nlm.nih.gov]
Nonviral causes can include bacteria (including Borrelia burgdorferi, Coxiella burnetii, Rickettsia rickettsii, Erlichia chaffeensis, Listeria monocytogenes, Mycobacterium tuberculosis) as well as parasites (Toxoplasma gondii, Trypanosoma brucei, Plasmodium [infectiousdiseaseadvisor.com]
Because of animal exposure and insect contact, Borrelia burgdorferi, Borrelia spp., Rickettsia spp., Bartonella, Coxiella burnetii, Anaplasma/Ehrlichia, Brucella, and Toxoplasma (serum and CFS) tests were performed and were negative. [virologyj.biomedcentral.com]
-
Rickettsia Rickettsii
Nonviral causes can include bacteria (including Borrelia burgdorferi, Coxiella burnetii, Rickettsia rickettsii, Erlichia chaffeensis, Listeria monocytogenes, Mycobacterium tuberculosis) as well as parasites (Toxoplasma gondii, Trypanosoma brucei, Plasmodium [infectiousdiseaseadvisor.com]
Other Pathologies
-
White Matter Lesions
Brain MRI is more sensitive than CT for identifying parenchymal gray or white matter lesions, and should be performed to exclude tumor, abscess, hemorrhage or other intracranial disease that can mimic encephalitis. [infectiousdiseaseadvisor.com]
HPeV3 causes necrotic white matter lesions indistinguishable from periventricular leukomalacia. [neuropathology-web.org]
Radiological investigations Computed tomography (CT) of the brain in ADEM can be normal but often shows non-specific, low attenuation subcortical white matter lesions that may or may not enhance. [jnnp.bmj.com]
Treatment
The interest of a diagnosis of encephalitis for which there is no specific treatment is also to discontinue any empirical treatments initially prescribed. Physicians must consider and search for autoimmune encephalitis. [ncbi.nlm.nih.gov]
Anti-infective agents Choice of treatment varies widely based on suspected or confirmed etiologic agent. Please see Table II for treatment options. Table II. Treatment options and adjunctive therapies for specific organisms. [infectiousdiseaseadvisor.com]
Since there are few types of encephalitis the treatment usually depends on the cause. [steadyhealth.com]
Prognosis
What should you tell the family about the patient's prognosis? The most predictive factor for prognosis in patients with encephalitis is the severity of disease. [infectiousdiseaseadvisor.com]
Prognosis Encephalitis causes high rates of illness and death. [ 1 ] The prognosis depends on the age of the patient and the underlying aetiology. [patient.info]
In addition, even experienced physicians often are uncertain about the cause, appropriate therapy, and prognosis. [pedsinreview.aappublications.org]
Worse prognosis if: extremes of age ( 55y) comorbidities immunodeficiency virulent organism References and links LITFL Anti-NMDA Receptor Encephalitis (CCC) HSV encephalitis (CCC) Journal articles Armangue T, Leypoldt F, Dalmau J. [lifeinthefastlane.com]
[…] autoimmune, certain medication, unknown [2] Diagnostic method Based on symptoms, supported by blood tests, medical imaging, analysis of cerebrospinal fluid [2] Treatment Antiviral medication, anticonvulsants, corticosteroids, artificial respiration [1] Prognosis [en.wikipedia.org]
Etiology
etiology in 56 (34%) patients. [ncbi.nlm.nih.gov]
Among patients for whom etiology was confirmed/probable, the etiologic pathogen was potentially treatable for 48%. [wwwnc.cdc.gov]
Epidemiology
The epidemiology of encephalitis is constantly evolving. Epidemiological data may indicate the emergence and/or dissemination of new causative agents. [ncbi.nlm.nih.gov]
Epidemiology, public health and medical rates databases. Revue d'Epidémiologie et de Santé Publique 2004 ; 52 : 113 – 117. ISSN: 0950-2688 EISSN: 1469-4409 URL: /core/journals/epidemiology-and-infection [cambridge.org]
(Epidemiology of encephalitis cases from California 1998-2005.) Clinical guidelines Tunkel, AR, Glaser, CA, Bloch, KC, Sejvar, JJ, Marra, CM, Roos, KL, Hartman, BJ, Kaplan, SL, Scheld, WM, Whitley, RJ. [infectiousdiseaseadvisor.com]
“Acute Bacterial meningitis in Infants and Children: Epidemiology and Management”. Peaediatr Drugs. 2011. (Good review of antibiotic choices.) National Institute for Health and Clinical Excellence: Guidance. [clinicaladvisor.com]
Pathophysiology
Herpes Simplex Virus-1 Encephalitis in Adults: Pathophysiology, Diagnosis, and Management. Neurotherapeutics. 2016; 13(3): 493-508. PubMed George BP, Schneider EB, Venkatesan A. [arupconsult.com]
Autoimmune Encephalitis Classification Autoimmune encephalitis Autoimmune encephalitis Diagnosis Autoimmune Encephalitis Pathophysiology [news-medical.net]
Its incidence in children was 0.2/100,000 – 0.4/100,000 in the published studies. 6 Patho-anatomy/physiology Pathophysiology of the disease depends on the infecting agent. [now.aapmr.org]
Post-acute serum eosinophil and neutrophil-associated cytokine/chemokine profile can distinguish between patients with neuromyelitis optica and multiple sclerosis; and identifies potential pathophysiological mechanisms—a pilot study. [journals.plos.org]
[…] soon as the diagnosis is suspected Always consider epidemiological factors that may indicate an unusual cause of encephalitis (e.g. arboviruses and zoonoses), especially in Australia Encephalitis is commonly fatal or results in significant morbidity PATHOPHYSIOLOGY [lifeinthefastlane.com]
Prevention
What can travelers do to prevent Japanese encephalitis? Travelers can protect themselves from JE by getting JE vaccine and preventing mosquito bites. [dartmouth-hitchcock.org]
The dissemination and emergence of causative agents are fostered by environmental, social, and economical changes, but prevention programs (vaccination, vector controls) help reduce the incidence of other infectious diseases and associated encephalitis [ncbi.nlm.nih.gov]
How can encephalitis be prevented? Varicella, measles, mumps, and influenza can be prevented with vaccine. HIV encephalitis is decreased in patients on highly active antiretroviral therapy (HAART). [infectiousdiseaseadvisor.com]
Measles, mumps and rubella (MMR) vaccine is a very effective way to prevent against these diseases. Read more Rabies Rabies is a severe viral infection of the brain and spinal cord that is transmitted by infected animals. [encephalitis.info]
How can encephalitis be prevented? The way to prevent encephalitis is to prevent the viral illness that can lead to a complication like encephalitis. [vdh.virginia.gov]