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Viral encephalitis: a practical review on diagnostic approach and treatment

tetano

Editor, Senior Moderator
J Pediatr (Rio J). 2019 Sep 9. pii: S0021-7557(19)30429-2. doi: 10.1016/j.jped.2019.07.006. [Epub ahead of print]
[h=1]Viral encephalitis: a practical review on diagnostic approach and treatment.[/h] Costa BKD[SUP]1[/SUP], Sato DK[SUP]2[/SUP].
[h=3]Author information[/h] 1 Pontif?cia Universidade Cat?lica do Rio Grande do Sul (PUC-RS), Hospital S?o Lucas, Departamento de Neurologia, Porto Alegre, RS, Brazil; Pontif?cia Universidade Cat?lica do Rio Grande do Sul (PUC-RS), Escola de Medicina, Porto Alegre, RS, Brazil. Electronic address: brunakleinc@gmail.com. 2 Pontif?cia Universidade Cat?lica do Rio Grande do Sul (PUC-RS), Hospital S?o Lucas, Departamento de Neurologia, Porto Alegre, RS, Brazil; Pontif?cia Universidade Cat?lica do Rio Grande do Sul (PUC-RS), Instituto do C?rebro, Porto Alegre, RS, Brazil.

[h=3]Abstract[/h] [h=4]OBJECTIVES:[/h] To review the diagnostic criteria for encephalitis and encephalopathy of presumed infectious etiology, as well as the diagnostic workup for viral encephalitis and its treatment approaches. The authors also intended to summarize relevant information on specific viruses frequently found in Brazil.
[h=4]SOURCE OF DATA:[/h] Literature search on Pubmed/MEDLINE using the following keywords: "viral," "encephalitis," "child," or "adolescents," filtering for articles on humans and in English.
[h=4]SUMMARY OF DATA:[/h] Viral encephalitis is the most common cause of encephalitis and is responsible for high rates of morbidity, permanent neurologic sequelae, and according to the virus, may have high mortality rates. The most common etiologies are herpesviruses 1 and 2 (HSV-1 and HSV-2), non-polio enterovirus, and arboviruses (in Brazil, dengue, Zika, and chikungunya). Other relevant etiologies are seasonal influenza, cytomegalovirus (CMV), Epstein-Barr virus (EBV), human herpesvirus 6 (HHV-6), and the re-emergent measles.
[h=4]CONCLUSION:[/h] Clinical data, laboratory results, and neuroimaging findings support the diagnosis of encephalitis and the specific viral etiology. To increase the likelihood of etiologic confirmation, it is important to know the best approach to collecting samples and to choose the best identification technique for each virus. The differential diagnosis of viral encephalitis includes other infections and immune-mediated inflammatory central nervous system disorders.
Copyright ? 2019. Published by Elsevier Editora Ltda.


[h=4]KEYWORDS:[/h] Diagnosis; Diagn?stico; Encefalite viral; Tratamento; Treatment; Viral encephalitis

PMID: 31513761 DOI: 10.1016/j.jped.2019.07.006
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