Viral Meningitis and Viral Encephalitis

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Description

Inflammation of the meninges covering the brain and spinal cord due to a viral infection. These cause severe
morbidity and mortality. Common causes include:

• Herpes Simplex Virus
• Epstein Barr Virus
• Cytomegalovirus
• Adenovirus

Sign and Symptoms

• Headache
• Neck stiffness
• Fever - May be low grade or no fever at all
• Seizures
• Altered consciousness
• Refusing to suck/feed/lethargy/irritability
• Nausea and/or vomiting

Treatment

Supportive

• Fever, pain and seizure control
• IF GCS low, insert NGT to minimize risk of aspiration. Can also be used for feeding
• Maintain good hydration. Cautious use of IV fluid . Adjust maintenance to 2/3 of calculated volume 
• Insert urethral catheter to monitor input/output

Pharmacological 

Infants > 1 month old: Aciclovir IV 30-60mg/kg/dose TDS with empirical antibiotic treatment for bacterial meningitis