Description: Clinical Infectious Diseases publishes clinically relevant articles on the pathogenesis, clinical investigation, medical microbiology, diagnosis, immune mechanisms, and treatment of diseases caused by infectious agents. Because treatment is more effective if given early, the topic of meningitis and encephalitis was chosen as an Emergency Neurological Life Support protocol. Herpes simplex can cause a benign lymphocytic meningitis in adults but usually produces a severe encephalitis in neonates. Herpetic encephalitis: a clinical case. The detection rate increased from 8.9% during the first year of the study to 14.8% during the second year of the study with improved methodology and an expanded panel of viral agents. All 137 meningitis patients made a good recovery. Testing CSF for multiple organisms has previously been problematic because it may be difficult to obtain enough fluid from the patient to run multiple tests4.
Viral meningitis usually resolves in 10 days or less, but other types of meningitis can be deadly if not treated promptly. Anyone experiencing symptoms of meningitis or encephalitis should see a doctor immediately. Patients with acute CNS infections generally present with similar findings of fever, headache, and neurological changes. The diagnosis of ABM depends on clinical features and the CSF profile. Anticonvulsants are used to prevent or treat seizures. Corticosteroids are used to reduce brain swelling and inflammation. Sedatives may be needed for irritability or restlessness.
Over-the-counter medications may be used for fever and headache. The clinical findings and neuroimaging appearance are both consistent with spread of the virus from a previously infected ganglion. Prognosis: The prognosis for encephalitis varies. Some cases are mild, short and relatively benign and individuals have full recovery. although the process may be slow. Other cases are severe, and permanent impairment or death is possible. The acute phase of encephalitis may last for 1 to 2 weeks, with gradual or sudden resolution of fever and neurological symptoms.
Neurological symptoms may require many months before full recovery. A faster TAT has been previously reported with implementation of rapid respiratory panel testing, resulting in a five- to six-hour savings over the standard of care testing.22 Beyond providing a STAT result, improving TAT can likely improve antimicrobial stewardship, infection control practices, and healthcare costs associated with CNS infections. However, in some cases, the disease progresses so rapidly that death occurs during the first 48 hours, despite early treatment.