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ISSN (Print): 1574-8871
ISSN (Online): 1876-1038

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Review Article

Viral Encephalitis in Adults: A Narrative Review

Author(s): Valentina Siciliano, Tommaso Rosà, Pierluigi Del Vecchio, Anna D'Angelillo, Mattia Brigida, Yaroslava Longhitano, Christian Zanza, Michele Cosimo Santoro, Marcello Candelli, Francesco Franceschi and Andrea Piccioni*

Volume 17, Issue 4, 2022

Published on: 29 April, 2022

Page: [259 - 267] Pages: 9

DOI: 10.2174/1574887116666211118141117

Price: $65

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Abstract

Viral infections of the central nervous system cause frequent hospitalization. The pathogenesis of viral encephalitis involves both the direct action of invading pathogens and the damage generated by the inflammatory reaction they trigger. The type of signs and symptoms presented by the patient depends on the severity and location of the ongoing inflammatory process. Most of the viral encephalitides are characterized by an acute development, fever, variable alterations in consciousness (confusion, lethargy, even coma), seizures (focal and generalized) and focal neurologic signs. The specific diagnosis of encephalitis is usually based on lumbar puncture. Cerebrospinal fluid examination should be performed in all patients unless absolutely contraindicated. Also, electroencephalogram and neuroimaging play a prominent role in diagnosis. Airway protection, ventilatory support, the management of raised intracranial pressure and correction of electrolyte disorders must be immediately considered in a patient with altered mental status. The only therapy strictly recommended is acyclovir in HSV encephalitis. The use of adjunctive glucocorticoids has poor-quality evidence in HSV, EBV, or VZV encephalitis. The role of antiviral therapy in other types of viral encephalitis is not well defined.

Keywords: Viral infection, central nervous system viral infection, encephalitis, haemophilus influenzae, herpesviridae infections, cerebrospinal fluid.

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