acyclovir and West-Nile-Fever

Encephalitis and postinfectious encephalitis represent two important conditions for the neurologist, both in terms of their presentations as neurologic emergencies and their potential to cause death or serious neurologic impairment. This article reviews the major infectious and noninfectious causes of encephalitis and discusses postinfectious encephalitis as an indirect effect of systemic illness.. Encephalitis caused by herpes simplex virus type 1 and West Nile virus are of major importance. In addition, within the past few years we have gained improved understanding of the neurologic syndromes caused by varicella-zoster virus, the recognition of enterovirus 71 as a significant human pathogen, and the realization that encephalitis may also occur by autoimmune mechanisms requiring immunosuppressive therapy. We have also learned that postinfectious encephalitis may be recurrent rather than monophasic, and that children and adults initially diagnosed with postinfectious encephalitis may later develop classic multiple sclerosis.. Encephalitis and postinfectious encephalitis present as neurologic emergencies requiring prompt diagnosis and initiation of treatment. Important concerns are to identify infectious conditions requiring antibiotic or antiviral therapy and postinfectious or other autoimmune encephalitides requiring immunosuppression.

Topics: Acyclovir; Adolescent; Antiviral Agents; Brain Diseases; Encephalitis; Encephalitis, Herpes Simplex; Encephalitis, Varicella Zoster; Encephalitis, Viral; Enterovirus Infections; Fatal Outcome; Female; Hashimoto Disease; Humans; Leukoencephalitis, Acute Hemorrhagic; Magnetic Resonance Imaging; Male; Middle Aged; West Nile Fever; Young Adult

Topics: Acyclovir; Antiviral Agents; Cat-Scratch Disease; Child; Encephalitis; Encephalitis, Herpes Simplex; Encephalomyelitis, Acute Disseminated; Enterovirus Infections; Epstein-Barr Virus Infections; Humans; Influenza, Human; Pneumonia, Mycoplasma; Prognosis; Rabies; West Nile Fever

Topics: Acyclovir; Anti-Infective Agents; Brain; Ceftriaxone; Ciprofloxacin; Consciousness Disorders; Humans; Magnetic Resonance Imaging; Male; Middle Aged; Paresis; Vancomycin; West Nile Fever; West Nile virus

Topics: Acute Disease; Acyclovir; Adult; Antibodies, Viral; Antiviral Agents; Cerebellar Ataxia; Female; Humans; Immunocompetence; West Nile Fever; West Nile virus

Topics: Acyclovir; Adult; Antibodies, Viral; Antiviral Agents; Female; Humans; Meningitis, Aseptic; Stuttering; West Nile Fever; West Nile virus

The objective of this study was to describe the clinical features of cases hospitalized with West Nile virus (WNV) infections and identify clinical parameters that could potentially predict poor outcome (death). Retrospective medical chart reviews were completed for 172 confirmed cases of WNV infection hospitalized in the Houston, Texas, metropolitan area between 2002 and 2004. Of the 172 patients, 113 had encephalitis which resulted in 17 deaths, 47 had meningitis, and 12 had uncomplicated fever. Risk factors associated with progression from encephalitis to death were absence of pleocytosis in the cerebrospinal fluid, renal insufficiency, requiring intubation and mechanical ventilation, presence of myoclonus or tremors, and loss of consciousness. These findings can aid physicians in evaluating their patients suspected of WNV infection and determining outcomes in their patients with confirmed WNV neuroinvasive disease.

Topics: Acyclovir; Adolescent; Adult; Aged; Aged, 80 and over; Anti-Bacterial Agents; Antiviral Agents; Child; Child, Preschool; Female; Hospitalization; Humans; Infant; Male; Middle Aged; Retrospective Studies; Risk Factors; Texas; West Nile Fever

West Nile Virus (WNV) infection is an important cause of encephalitis. Although the medical literature contains examples of WNV encephalitis in susceptible, mainly elderly, immunocompromised hosts, few case reports have described pediatric cases. The authors describe an adolescent with acute lymphocytic leukemia and WNV encephalitis. Surveillance studies indicate an increase in WNV activity. Physicians need to be aware of WNV activity in their community and consider WNV as a potential source of infection.

Topics: Acyclovir; Adolescent; Animals; Antibodies, Viral; Antineoplastic Combined Chemotherapy Protocols; Antiviral Agents; Brain; Ceftazidime; Ceftriaxone; Culicidae; Diagnosis, Differential; Encephalitis, Viral; Fatal Outcome; Humans; Immunoglobulins, Intravenous; Insect Bites and Stings; Magnetic Resonance Imaging; Male; Mercaptopurine; North Carolina; Persistent Vegetative State; Precursor Cell Lymphoblastic Leukemia-Lymphoma; Prednisone; Vancomycin; Vincristine; Virginia; West Nile Fever; West Nile virus

Topics: Acyclovir; Antiviral Agents; Canada; Netherlands; Travel; West Nile Fever; West Nile virus

Topics: Acyclovir; Ceftriaxone; Child, Preschool; Communicable Diseases, Emerging; Drug Therapy, Combination; Follow-Up Studies; Glasgow Coma Scale; Humans; Infusions, Intravenous; Male; Ontario; Risk Assessment; Severity of Illness Index; Treatment Outcome; West Nile Fever; West Nile virus