Abstract
For most clinicians managing a patient with encephalitis will be an infrequent event. The range of differential diagnoses in a child presenting with a clinical syndrome that could be encephalitis is broad. In addition, there are many pathogens that can cause encephalitis. In view of these facts, a systematic approach to clinical assessment, investigation and treatment, based on epidemiology and an understanding the limits of investigations, is crucial to effective management of this condition. This review focuses on encephalitis aetiology and investigation; HSV encephalitis; mycoplasma encephalitis; and flavivirus encephalitis as a globally important cause of disease.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Thompson C, Kneen R, Riordan A, Kelly D, Pollard AJ (2012) Encephalitis in children. Arch Dis Child 97(2):150–161
Long SS (2011) Encephalitis diagnosis and management in the real world. Adv Exp Med Biol 697:153–173
Tunkel AR, Glaser CA, Bloch KC, Sejvar JJ, Marra CM, Roos KL et al (2008) The management of encephalitis: clinical practice guidelines by the Infectious Diseases Society of America. Clin Infect Dis 47(3):303–327
Kneen R, Michael BD, Menson E, Mehta B, Easton A, Hemingway C et al (2012) National guideline for the management of suspected viral encephalitis in children. J Infect 64(5):449–477
Kolski H, Ford-Jones EL, Richardson S, Petric M, Nelson S, Jamieson F et al (1998) Etiology of acute childhood encephalitis at The Hospital for Sick Children, Toronto, 1994–1995. Clin Infect Dis 26(2):398–409
Glaser CA, Gilliam S, Schnurr D, Forghani B, Honarmand S, Khetsuriani N et al (2003) In search of encephalitis etiologies: diagnostic challenges in the California Encephalitis Project, 1998–2000. Clin Infect Dis 36(6):731–742
Granerod J, Ambrose HE, Davies NW, Clewley JP, Walsh AL, Morgan D et al (2010) Causes of encephalitis and differences in their clinical presentations in England: a multicentre, population-based prospective study. Lancet Infect Dis 10(12):835–844
Granerod J, Crowcroft NS (2007) The epidemiology of acute encephalitis. Neuropsychol Rehabil 17(4–5):406–428
Granerod J, Tam CC, Crowcroft NS, Davies NW, Borchert M, Thomas SL (2010) Challenge of the unknown. A systematic review of acute encephalitis in non-outbreak situations. Neurology 75(10):924–932
Fowler A, Stodberg T, Eriksson M, Wickstrom R (2008) Childhood encephalitis in Sweden: etiology, clinical presentation and outcome. Eur J Paediatr Neurol 12(6):484–490
Willoughby RE Jr., Tieves KS, Hoffman GM, Ghanayem NS, Amlie-Lefond CM, Schwabe MJ et al (2005) Survival after treatment of rabies with induction of coma. N Engl J Med 352(24):2508–2514
Whitley RJ, Alford CA, Hirsch MS, Schooley RT, Luby JP, Aoki FY et al (1986) Vidarabine versus acyclovir therapy in herpes simplex encephalitis. N Engl J Med 314(3):144–149
Whitley RJ, Kimberlin DW (2005) Herpes simplex encephalitis: children and adolescents. Semin Pediatr Infect Dis 16(1):17–23
Kimberlin DW, Lin CY, Jacobs RF, Powell DA, Corey L, Gruber WC et al (2001) Safety and efficacy of high-dose intravenous acyclovir in the management of neonatal herpes simplex virus infections. Pediatrics 108(2):230–238
De Tiege X, Heron B, Lebon P, Ponsot G, Rozenberg F (2003) Limits of early diagnosis of herpes simplex encephalitis in children: a retrospective study of 38 cases. Clin Infect Dis 36(10):1335–1339
Baskin HJ, Hedlund G (2007) Neuroimaging of herpesvirus infections in children. Pediatr Radiol 37(10):949–963
Kelly D, Kroll JS (2004) Encephalitis—beyond aciclovir. Adv Exp Med Biol 549:177–183
Elbers JM, Bitnun A, Richardson SE, Ford-Jones EL, Tellier R, Wald RM et al (2007) A 12-year prospective study of childhood herpes simplex encephalitis: is there a broader spectrum of disease? Pediatrics 119(2):399–407
Chan PK, Chow PC, Peiris JS, Mak AW, Huen KF (2000) Use of oral valaciclovir in a 12-year-old boy with herpes simplex encephalitis. Hong Kong Med J 6(1):119–121
Pouplin T, Pouplin JN, Van Toi P, Lindegardh N, Rogier van Doorn H, Hien TT et al (2011) Valacyclovir for herpes simplex encephalitis. Antimicrob Agents Chemother 55(7):3624–3626
Musallam B, Matoth I, Wolf DG, Engelhard D, Averbuch D (2007) Steroids for deteriorating herpes simplex virus encephalitis. Pediatr Neurol 37(3):229–232
Kamei S, Sekizawa T, Shiota H, Mizutani T, Itoyama Y, Takasu T et al (2005) Evaluation of combination therapy using aciclovir and corticosteroid in adult patients with herpes simplex virus encephalitis. J Neurol Neurosurg Psychiatry 76(11):1544–1549
German Trial of Aciclovir and Corticosteroids in Herpes Simplex Encephalitis (GACHE). http://www.klinikum.uni-heidelberg.de/index.php?id = 4223&L = en
Bitnun A, Ford-Jones EL, Petric M, MacGregor D, Heurter H, Nelson S et al (2001) Acute childhood encephalitis and Mycoplasma pneumoniae. Clin Infect Dis 32(12):1674–1684
Koskiniemi M, Vaheri A (1989) Effect of measles, mumps, rubella vaccination on pattern of encephalitis in children. Lancet 1(8628):31–34
Bitnun A, Richardson SE (2010) Mycoplasma pneumoniae: Innocent Bystander or a True Cause of Central Nervous System Disease? Curr Infect Dis Rep 12(4):282–290
Tong CY, Menson E, Lin JP, Lim M (2011) Prevalence of mycoplasma encephalitis. Lancet Infect Dis 11(6):425–426
Narita M (2009) Pathogenesis of neurologic manifestations of Mycoplasma pneumoniae infection. Pediatr Neurol 41(3):159–166
Jaruratanasirikul S, Hortiwakul R, Tantisarasart T, Phuenpathom N, Tussanasunthornwong S (1996) Distribution of azithromycin into brain tissue, cerebrospinal fluid, and aqueous humor of the eye. Antimicrob Agents Chemother 40(3):825–826
Esposito S, Tagliabue C, Bosis S, Principi N (2011) Levofloxacin for the treatment of Mycoplasma pneumoniae-associated meningoencephalitis in childhood. Int J Antimicrob Agents 37(5):472–475
Solomon T (2004) Flavivirus encephalitis. N Engl J Med 351(4):370–378
Campbell GL, Hills SL, Fischer M, Jacobson JA, Hoke CH, Hombach JM et al (2011) Estimated global incidence of Japanese encephalitis: a systematic review. Bull World Health Organ 89(10):766–774, 74A–74E
Hoke CH Jr., Vaughn DW, Nisalak A, Intralawan P, Poolsuppasit S, Jongsawas V et al (1992) Effect of high-dose dexamethasone on the outcome of acute encephalitis due to Japanese encephalitis virus. J Infect Dis 165(4):631–637
Solomon T, Dung NM, Wills B, Kneen R, Gainsborough M, Diet TV et al (2003) Interferon alfa-2a in Japanese encephalitis: a randomised double-blind placebo-controlled trial. Lancet 361(9360):821–826
Murray KO, Mertens E, Despres P (2010) West Nile virus and its emergence in the United States of America. Vet Res 41(6):67
Jackson AC (2004) Therapy of West Nile virus infection. Can J Neurol Sci 31(2):131–134
Mansfield KL, Johnson N, Phipps LP, Stephenson JR, Fooks AR, Solomon T (2009) Tick-borne encephalitis virus—a review of an emerging zoonosis. J Gen Virol 90(Pt 8):1781–1794
HPA (2011) Louping ill. 2011 (cited 15 Jan 2012). http://www.hpa.org.uk/Topics/InfectiousDiseases/InfectionsAZ/LoupingIll/
Guffond T, Dewilde A, Lobert PE, Lefebvre DC, Hober D, Wattre P (1994) Significance and Clinical Relevance of the Detection of Herpes-Simplex Virus-DNA by the Polymerase Chain-Reaction in Cerebrospinal-Fluid from Patients with Presumed Encephalitis. Clin Infect Dis 18(5):744–749
Studahl M, Bergstrom T, Hagberg L (1998) Acute viral encephalitis in adults—a prospective study. Scand J Infect Dis 30(3):215–220
Weil AA, Glaser CA, Amad Z, Forghani B (2002) Patients with suspected herpes simplex encephalitis: rethinking an initial negative polymerase chain reaction result. Clin Infect Dis 34(8):1154–1157
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2013 Springer Science+Business Media New York
About this chapter
Cite this chapter
Kelly, D. (2013). An Encephalitis Primer. In: Curtis, N., Finn, A., Pollard, A. (eds) Hot Topics in Infection and Immunity in Children IX. Advances in Experimental Medicine and Biology, vol 764. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-4726-9_10
Download citation
DOI: https://doi.org/10.1007/978-1-4614-4726-9_10
Published:
Publisher Name: Springer, New York, NY
Print ISBN: 978-1-4614-4725-2
Online ISBN: 978-1-4614-4726-9
eBook Packages: Biomedical and Life SciencesBiomedical and Life Sciences (R0)