ENCEPHALITIS
Dive into the intricacies of Encephalitis, focusing on specific viral causes and tailored treatment approaches. Uncover detailed protocols for HSV Encephalitis, Herpes Virus 6 Encephalitis, CMV, VZV, and B Virus, along with recommendations for possible tick exposure.
2023-12-20 10:33:47 - Editor
HSV Encephalitis
Acyclovir 10mg/kg IV q 8h for 14-21 days. Repeat HSV PCR, if positive, treat until negative
Neonate dose : 20mg/kg
Herpes virus 6 Encephalitis
Ganciclovir 5mg/kg IV q12 h x 14 - 21 days; Then 5mg/kg daily (if HIV +) OR Foscarnet 90 mg/kg IV q 12h x 14 days; Then 90 mg/kg daily (if HIV +)
CMV
Same meds as for HSV6
If HIV +, add HAART also
VZV
Acyclovir 10mg/kg IV q 8h x 2 weeks OR Ganciclovir
B Virus
Ganciclovir 5 mg/kg IV q 12 h x 14 days OR Acyclovir 15mg/kg IV q 8h x 14 days
This is followed by Acyclovir 800 mg po five times daily or Valacyclovir 1 gm po tid indefinitely
Possible Tick Exposure (RMSF / Ehrlichia)
Doxycycline 200 mg load followed by 100 mg q 12h
Listeria Encephalitis
Ampicillin 2 gm IV q 4 h PLUS Gentamicin5 mg/kg/day in 3 divided doses, for 3 - 6 weeks OR TMP/SMX 15 mg/kg/day in 3 divided doses for 3- 6 weeks
Toxoplasma Encephalitis
Pyrimethamine 100-200 mg po X 1 , followed by 50-100 mg po daily PLUS Clindamycin 900 mg IV q 6h x 6 weeks (Alternative: Sulfadiazine 4-8 gm po daily)
Investigations in Encephalitis
CSF PCR: HSV, VZV, EBV, Enterovirus, WNV
CSF other tests: RPR, Borrelia Burgdorferi, Crypt Antigen, Histoplasma Antigen
IgG Toxoplasma Gondii
Blood PCR: Ehrlichia
Serology: R.Rickettsii
If immunocompromised : CMV, JC, HHV-6