The only exception is herpes simplex virus, which is treated with iv antiviral medicine. The emergence of unusual forms of zoonotic encephalitis has posed an important public health problem. The single most frequent cause of sporadic encephalitis around the world is herpes simplex. Bacterial meningitis american academy of pediatrics. Chief, division of infectious disease, childrens hospital and medical center, seattle, wa. Clinical and paraclinical characteristics of bacterial. Diagnostico diferencial segun caracteristicas del lcr. Viral meningitis is a notifiable disease in england and wales, but many cases undoubtedly go unreported. Enteroviruses are spread by direct contact with feces during activities such as diaper changing or indirectly through contaminated water, food, and. Viral meningitis the most common cause of viral meningitis is a family of viruses called enterovirus. Bronquiectasias en pediatria, aproximacion diagnostica y tratamiento. Most cases of recurrent viral meningitis are caused by hsv2.
Meningitis is usually caused by a bacterial or viral infection that invades the cerebral spinal fluid csf. Summary while meningitis and encephalitis caused by viruses may have some clinical overlap, the management and outcomes can be highly disparate, making distinction between the two imperative. Diagnosis, initial management, and prevention of meningitis david m. Hsv1 typically causes encephalitis rather than meningitis. In some cases, treatment may be done to help ease symptoms.
In the united states, enteroviral meningitis is seen more frequently from june to october. The infectious diseases management program idmp at ucsf is an interprofessional and interhospital collaboration aimed at improving antimicrobial use and the care of patients with infections. This article will address three broad areas of viral encephalitisits causes, differential diagnosis, and management. These studies have been hampered by incomplete aetiological approaches. Encefalitis viral infantil 83 medicina buenos aires 20. Professor, departments of pediatrics and microbiology, school of medicine, university of washington. Clinical features and diagnosis in children, section on diagnosis. Vaccination and vector control measures are useful preventive strategies in certain arboviral and zoonotic encephalitis. These are guidelines only and not intended to replace clinical judgment. However, many of the viruses discussed are highly preventable by vaccination, proper skin protection against transmitting vectors, and postexposure prophylaxis. Ct of viral lower respiratory tract infections in adults. Encefalitis viral por herpes virus simple an med mex 2016. A confirmed or probable causative agent was identified in only 16% of cases. The spectrum of brain involvement and the prognosis are dependent mainly on the speci.
Cerebral spinal fluid csf is the fluid within the open spaces of the brain that protect and cushion the brain and spinal cord. Many published studies have addressed the differentiation of bacterial from viral pneumonia using clinical, 2 5 radiological, 2 9 and routine haematological tests, 2 5, 9 11 but these methods have not been found to be sufficiently reliable in differential diagnosis. Diagnosis, initial management, and prevention of meningitis. Echovirus y herpes simplex pueden causar hipoglicorraquia. Bamberger, md, university of missourikansas city school of medicine, kansas city, missouri. Differentiation of bacterial and viral pneumonia in. A significant percentage remains without a definitive diagnosis due to the large number of etiologic agents. Bacterial meningitis is a serious, relatively common childhood disease that affects approximately 1 in 500 children who are younger than 2 years. However, we need better antiviral therapy to meet the challenge of acute viral encephalitis more effectively. Acute encephalitis can be due to many causes, although most are viral, and is a medical emergency.
Doses provided are usual doses but may require modification based on patient age or comorbid conditions. Pending results of csf cultures and virologic studies, the results of the initial evaluation can be used to make a provisional diagnosis of bacterial meningitis, viral meningitis, or unclear etiology. Modification of therapy may be indicated based on patient comorbidities, previous antibiotic therapy or infection history. Clinical manifestations and relevant environmental and personal information the diagnosis of viral encephalitis is suspected in the context of a febrile disease accompanied by headache. There are no medicines to treat the viruses that cause viral meningitis. Of identifiable causes, 69% were viral, 20% bacterial, 8% noninfectious ie, autoimmune disease, 7% prion protein, 3% parasitic, and 1% fungal. Most children get better on their own without treatment.
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