Treatment
Treatment is usually empirical to begin with, unless there is a clear idea of the aetiology. Thus, modalities include:
- intravenous acyclovir, to cover herpes simplex. Given before the patient enters coma, this treatment has massively improved the prognosis.
- intravenous broad spectrum antibiotics
- intravenous mannitol, to reduce cerebral oedema
- intravenous dextrose or dextrose saline, to maintain the blood glucose. The usual fluid management is restriction to two thirds maintenance, again to reduce cerebral oedema.
Other measures are supportive.
Reference:
- Ellul M, Solomon T. Acute encephalitis - diagnosis and management. Clin Med (Lond). 2018 Mar;18(2):155-159
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