Encephalitis is an important cause of encephalopathy in childhood. Although encephalitis may be difficult to differentiate from other causes of encephalopathy in its early stages, the timely use of specific treatments can prevent morbidity and mortality. A wide variety of organisms can cause encephalitis but viruses predominate. The most prevalent causative organisms vary with geography, season, and local vaccination schedules. In most industrialized countries herpes simplex virus (HSV) is the commonest single cause of sporadic encephalitis (Whitley and Lakeman, 1995). It is the only cause of viral encephalitis for which effective specific therapy, in the form of aciclovir, is available. Thus two important practical decisions are required of physicians confronted by an encephalopathic child: Whether to start treatment with aciclovir urgently, before the diagnosis is established; and having done so, how to rationalize treatment as more information becomes available. Therapeutic issues will become increasingly complex as the list of antiviral agents lengthens and as increasing international travel broadens the differential diagnosis. Knowledge of international epidemiology and technical assistance in making a quick and accurate diagnosis are therefore very important. Advances in viral diagnostic techniques—in particular the wide use of PCR—has greatly enhanced our ability to make a specific diagnosis rapidly enough to be clinically relevant.
KeywordsMycoplasma Pneumoniae Herpes Simplex Virus Encephalitis Japanese Encephalitis Viral Encephalitis Negative Polymerase Chain Reaction Result
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