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Treatment: Treatable types of encephalitis are viral and bacterial in origin, autoimmune potentially using steroids
Treatment usually starts in the ER, and progresses to the ICU
Encephalitis treatment ultimately comes down to the risk factors associated with the patient (prior history of travel, HIV status)
Usually use empiric antibiotics (broad-spectrum, does not require a differential diagnosis of the type of
If the case is sufficiently severe to suspect encephalitis, the treatment usually starts before the final diagnosis is determined
Signs and symptoms: 24 hour period of altered state of consciousness is the criteria for considering encephalitis
HSV encephalitis is often associated with the most bizarre behaviour
Age is very important for symptoms – kids often present with more irritability and have In children, different ages also have different prevalence of the causes of encephalitis – so age is a risk factor, and thus may influence the type of treatment is pursued
Age is also important in terms of vaccination status (some common vaccinated bugs can be causes of encephalitis e.g. varicella-zoster virus)
Focal neurological deficits may indicate meningitis that has progressed into encephalitis – any time these deficits are observed, need to do a CT FIRST before a lumbar puncture
Presentation can be very ambiguous
Causes: In Canada, the most common cause of bacterial encephalitis is most likely bacterial meningitis that has progressed to encephalitis
Check out life in the fast lane blog page on encephalitis The causes that are listed in this page are relevant enough to be explicitly elaborated in the Wikipedia article
For the ordering of the content in the causes section, order the material by prevalence and relevance first (HSV first because it is the most common cause, not rabies, which is more rare).
Prognosis: For prognosis, can include a section but should state that what really matters is how far along the patients are when they present to the ER. With treatment, most patients can resume (most of) their original mental state
Epidemiology: In epidemiology, get rid of the map (there are more recent statistics that contradict it!)
Bacterial and viral encephalitis are different in their prevalence (bacterial is usually in immunocompromised people only)