Encephalitis

Presenting features include drowsiness, coma, agitation, pyrexia, seizures and focal signs; meningism need not necessarily be present.

Causes:

• Bacterial (as for meningitis)

• Viruses (in particular, herpes simplex and post-measles, chicken pox, mumps infection). Herpes simplex classically affects the temporal lobe and can be diagnosed by EEG. Give aciclovir 10 mg/kg tds IV for 10 days.

Rarer causes include leptospirosis and brucellosis; the CSF reveals no organisms but a high lymphocyte count is present. If indicated, send CSF for acid fast stain (TB) and India Ink stain (Cryptococcus).

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