Encephalitis

shreya yadav
nursing tutor
st. catherines hospital

1. ENCEPHALITIS

2. DEFENITION Encephalitis is an acute inflammation of the brain, is a serious and sometimes fatal disease.

3. Etiology Virus Herpes Simplex virus HSV 1(children and adults) HSV 2(neonates) Arbo virus Cytomegalo virus encephalitis(AIDS)

4. Fungus : Cryptococcus neoformans Histoplasma capsulatum Candida

5. CLINICAL MANIFESTATION FEVER HEADACHE NAUSEA VOMITING

6. CNS abnormality include Hemiparesis Tremors Seizures Personality changes Memory impairment Amnesia Dysphasia

7. Diagnostic measures LP CSF pressure – normal or slight increase(60-150mmof water) WBC count- 500/ microlitre (0-8/ microlitre ) Protein – slight increase(15-45mg/dl) Glucose – normal(45-75mg)

8. Brain imaging techniques MRI,PET,EEG Helps in early detection of HSV(Swelling of the brain) Blood / Urine/ Excretions from the back of the throat- can be tested for virus EEG- abnormal patterns Blood test will detect viral RNA

9. MANAGEMENT Symptomatic and supportive management Mosquito control Acyclovir and vidarabine Anti seizure drugs For maximal benefit antiviral agents should be started before the onset of coma

10. BRAIN ABSCESS Is an accumulation of pus within the brain tissue that can result from a local or systemic infection.

11. ETIOLOGY Direct extension from ear, tooth, mastoid, or sinus infection Spread from distant sites( pulmn infection, bacterial endocarditis) Skull fracture Prior brain trauma surgery

12. Staphylo coccus aureus and strepto cocci

13. CLINICAL MANIFESTATION Headache Fever Nausea Vomiting Signs of increased ICP include drowsiness, confusion and seizures

14. Focal symptoms Temporal lobe abscess Visual field defects Psychomotor seizures Occipital abscess Visual impairement Hallucinations

15. Diagnostic measures CT MRI Verifying the presence size and number of abscess

16. MANAGEMENT Antimicrobial therapy(6-8weeks) Penicillin Chloramphenicol Metronidazole Third generation cephalosporin Draining of abscess or removal of abscess Abscess larger than 2.5cm are excised and aspirated Corticosteroids