Encephalitis -

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ENCEPHALITIS

Encephalitis literally means an inflammation of the brain, but it usually refers to brain inflammation caused by a virus. It may also be called “acute viral encephalitis or aseptic encephalitis';. Encephalitis is an infectious disease of the Central Nervous System characterized by pathologic changes in both the gray and white matter of the spinal cord and brain. It may be due to specific disease entity such as rabies or an arthropod-borne virus (arbovirus), or it may occur as a sequela of influenza, measles, German measles, chicken pox, herpes virus infection, small pox, vaccinia, or other diseases. The specific viruses involved may vary. Exposure can also occur through insect bites, food or drink, or skin contact.

Once the virus has entered the blood stream, it can localize the brain causing inflammation of brain cells and surrounding measures. White blood cells invade the brain tissue as they try to fight off the infection. The brain tissue swells (cerebral edema) and can cause destruction of nerve cells, bleeding with in the brain (intracerebral hemorrhage), and brain damage. This can cause neurologic deficits such as parplysis, speech changes, increased intracranial pressure, respiratory failure, seizure disorders, and shock can occur.

SIGNS AND SYMPTOMS

Mild cases absent superficial reflexes
Sudden fever *** exaggerated deep tendon reflexes
Poor appetite opisthotnos
Loss of energy nuchal rigidity
General sick feeling increases resp. tract problems

Severe Cases
High fever sore throat
Severe HA *** malaise
N/V *** ...

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90% resp. tract infection
5 to 7% prior illnes (chicken pox)

S/S: 5-7 days after viral illness, n/v, mental changes, lethargy, indifference, confusion, delirious, rapid breathing as progresses breathing sluggish, seizures, coma may die

TX: no cure support heart, lung, and brain function Keep blood levels balanced. ICU. Blood samples, I&O, adjusting blood by IV, b/p, icp, breathing monitored

1st recognized in 1963 by acute encephalopathy and fatty infiltration of liver and pancreas, heart, kidney, spleen, and lymph nodes. Mortality rate as high as 80%

S/S: hepatomegaly without jaundice in 40%, encephalopathy and altered liver function, combative behavior

TX: blood electrolytes controlled carefully, liver biopsy

NI: Neurological assessment, temp, alleviate hyperthermia, seizure precautions, I&O, impaired hepatic function, (signs of bleeding), tell don’t give aspirin.

Peak incidence age 6. 1st noted in 1974 with 400 cases following epidemics of influenza B outbreak and chicken pox

TX: aggressive support to correct metabolic abnormalities (hypoglycemia) and hemorrhage from blood clotting disorders

Since 1987 no more than 35 cases/yr nation wide (usually

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