title: Viral encephalitis in the ICU.
abstract: Viral encephalitis causes an altered level of consciousness, which may be associated with fever, seizures, focal deficits, CSF pleocytosis, and abnormal neuroimaging. Potential pathogens include HSV, VZV, enterovirus, and in some regions, arboviruses. Autoimmune (eg, anti-NMDA receptor) and paraneoplastic encephalitis are responsible for some cases where no pathogen is identified. Indications for ICU admission include coma, status epilepticus and respiratory failure. Timely initiation of anti-viral therapy is crucial while relevant molecular and serological test results are being performed. Supportive care should be directed at the prevention and treatment of cerebral edema and other physiological derangements which may contribute to secondary neurological injury.
authors.affiliation: Department of Critical Care Medicine and Clinical Neurosciences, Foothills Medical Center, McCaig Tower, 3134 Hospital Drive NW, Calgary, AB T2N 2T9, Canada. Andreas.Kramer@albertahealthservices.ca
authors.forename: Andreas H
authors.initials: AH
authors.lastname: Kramer
mesh_terms: D000212:Acyclovir / Q000008:administration & dosage* / Q000009:adverse effects / Q000627:therapeutic use; D000305:Adrenal Cortex Hormones / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D000927:Anticonvulsants / Q000008:administration & dosage / Q000627:therapeutic use; D000998:Antiviral Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D001927:Brain Diseases / Q000188:drug therapy / Q000209:etiology; D001929:Brain Edema / Q000209:etiology / Q000517:prevention & control; D003244:Consciousness Disorders / Q000209:etiology / Q000821:virology; D004660:Encephalitis; D018792:Encephalitis, Viral / Q000150:complications / Q000188:drug therapy / Q000453:epidemiology / Q000821:virology; D004673:Encephalomyelitis, Acute Disseminated / Q000188:drug therapy / Q000209:etiology* / Q000821:virology; D015600:Glasgow Coma Scale; D020275:Guillain-Barre Syndrome / Q000209:etiology / Q000821:virology; D050031:Hashimoto Disease / Q000188:drug therapy / Q000209:etiology; D006801:Humans; D007362:Intensive Care Units / Q000706:statistics & numerical data; D020361:Paraneoplastic Syndromes, Nervous System / Q000188:drug therapy / Q000209:etiology / Q000821:virology; D012640:Seizures / Q000188:drug therapy / Q000209:etiology / Q000821:virology; D013226:Status Epilepticus / Q000188:drug therapy / Q000209:etiology / Q000821:virology; D014766:Viremia / Q000209:etiology* / Q000821:virology
chemical_list: D000305:Adrenal Cortex Hormones; D000927:Anticonvulsants; D000998:Antiviral Agents; D000212:Acyclovir
keywords: Acute disseminated encephalomyelitis (ADEM); Anti-NMDA receptor antibodies; Arbovirus; Coma; Encephalitis; Herpes simplex virus; Varicella zoster virus; West Nile virus