Aseptic encephalitis

CDC Case Definition Arboviral infections may be asymptomatic or may result in illnesses of variable severity sometimes associated with central nervous system (CNS) involvement. When the CNS is affected, clinical syndromes ranging from febrile headache to aseptic meningitis to encephalitis may occur, and these are usually indistinguishable from similar syndromes caused by other viruses. Arboviral meningitis is characterized by fever, headache, stiff neck, and pleocytosis. Arboviral encephalitis is characterized by fever, headache, and altered mental status ranging... 

After incubation, initial clinical manifestations include fever, cough, chills, myalgia, headache, and sometimes pleuritic chest pain. Approximately 50% of patients show abnormal chest x-rays patchy infiltrates resemble viral disease. Uncommon complications include endocarditis, hepatitis, aseptic meningitis, encephalitis, and osteomyelitis. Most patients who develop endocarditis have preexisting valvular heart disease.3... 

An increased IgA index is found in aseptic meningitis in 40% of cases and in herpes encephalitis in almost 100% of cases as a result of virus-specific IgA antibody production. In neuromberculosis, an increased IgA index is often accompanied by normal IgC and IgM indices (LI). 

The frequency of central nervous system adverse effects is 1-9%. Headache, dizziness, vertigo, insomnia, drowsiness, and agitation have been reported. Hallucinatory symptoms and generalized tonic-clonic seizures have also been described (SEDA-16, 109). Toxic encephalitis can be part of a general toxic reaction (2). Diclofenac provoked aseptic meningitis in patients with systemic lupus erythematosus (SEDA-17,109). 

Previous observations have shown that most patients who develop aseptic meningitis or encephalitis due to LCMV recover completely. No chronic infection has been described in humans, and after the acute phase the virus is cleared. However, as in all infections of the central nervous system, particularly encephalitLs, temporary or permanent neurological damage is possible. Nerve deafness and arthritis have been reported. Infection of the human fetus during the early states of pregnancy may lead to developmental deficits that are permanent. 

Aseptic meningitis, encephalitis, or meningoencephalitis requires hospitalization and supportive treatment based on severity. There is no specific drug therapy for LCM. Anti-inflammatory drugs, such as corticosteroids, may be con.sidered under specific circumstances. Altliough studies have shown that ribavirin, a drug used to treat several other viral diseases, is effective against LCMV in vitro, there is no established evidence to support its use for treatment of LCM in humans. 

Chest pain or cough (25%), hepatitis, endocarditis, encephalitis, pneumonia, aseptic meningitis,... 

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