Infectious encephalitis: Management without etiological diagnosis 48hours after onset

Area of Science:

• Neurology
• Infectious Diseases
• Immunology

Background:

• Etiological diagnosis of infectious encephalitis is frequently delayed beyond 48 hours post-onset.
• Timely diagnosis is crucial for effective management and treatment of encephalitis.

Purpose of the Study:

• To review existing literature on infectious encephalitis diagnosis and management.
• To provide evidence-based guidelines for the clinical approach to encephalitis.

Main Methods:

• Systematic literature search conducted on PubMed.
• Included studies published since 2000, focusing on human adults in English or French.
• Utilized Mesh terms: "encephalitis/therapy" and "encephalitis/diagnosis", supplemented with "encephalitis and corticosteroid" and "encephalitis and doxycycline".

Main Results:

• Extensive literature retrieved, with 210 articles ultimately included in the analysis.
• Specific searches identified relevant studies on encephalitis therapy, diagnosis, corticosteroid, and doxycycline treatments.

Conclusions:

• Etiological investigations should consider travel history, animal exposure, patient demographics, immune status, and clinical presentation.
• Discontinuation of empirical treatments is advised when specific treatments are unavailable.
• Physicians should actively investigate and consider autoimmune encephalitis as a differential diagnosis.