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Showing posts with label encephalitis. Show all posts
Showing posts with label encephalitis. Show all posts

Tuesday, May 31, 2011

A Family Doctor's Tale - ENCEPHALITIS

DOC I HAVE ENCEPHALITIS

Encephalitis is a serious medical disease which causes inflammation and infection of the brain.

The causes of Encephalitis may be divided into:

Infections:
1.viral infections are the most common
(herpes simplex virus, mumps, measles, rubella, chickenpox, West Nile Encephalitis, Japanese Encephalitis, St Lious Encephalitis).

Of these viruses, herpes simplex virus is the most serious and can cause fatality.

2.bacterial infections such as meningoccocus (Neisseria meningitidis) and pneumococcus(Streptococcus pneumoniae) can be serious and fatal in some cases.

Meningococcal Encephalitis can cause outbreaks(spread easily).

3.fungi,
Cryptococcus neoformans is the most common cause of fungal Encephalitis

4.Parasitic
Examples are Toxoplasmosis, malaria, amoeba, Lyme Disease

The symptoms which often defines Encephalitis are:

1.Severe headache

2.Fever

3.Irritabilty

4.Confusion

5.Drowsiness and fatigue

Other symptoms are:

6.seizures and convulsions

7.vomiting

8.hallucinations

9.memory problems

10.tremors

11.weakness of the hands and legs

12.incontinence of urinary and bowel movement

The diagnosis of Encephalitis is made by:
1.Typical symptoms of fever, headache, confusion .

2.Physical examination shows confusion ,drowsiness and signs of neck rigidity

3.blood tests (complete blood count, ESR and blood culture)

4.cerebrospinal fluid analysis (CSF) via lumbar puncture is examined for increased white blood cells and protein content,  normal glucose level. Red blood cells may be present if there is bleeding. Sometimes the CSF may show the presence of micro-organisms.

This test should not be done if there is suspected cerebral mass lesion or raised intracranial pressure (head injury, localizing neurological signs, or signs of raised ICP).

5.CT or MRI of the brain and spine with MRI preferred over CT because it can detect more easily areas of cerebral edema,tumors, ischemia, and meningeal inflammation.

The complications of Encephalitis are:
1.Neurological deficits

2.deafness

3.learning disorders in children

4.brain infarction,

5.septic shock,

6.adult respiratory distress syndrome

7.seizures also more in children

8.pneumonia especially in the elderly

The treatment of Encephalitis is:
1.Hospitalisation should be immediate as Encephalitis can be a life threatening condition.

2.Antibiotics such as cephalosporin, ampicillin, chloramphenicol, intravenous vancomycin to be started even before doing lumbar puncture.

Acyclovir may be given for herpes virus infection

High dosages of antifungals may be given for Fungal Encephalitis for a prolonged period of time

3.corticosteroids is useful to reduce swelling and inflammation in the brain

4.Sedatives may be needed for irritabilty and restlessness

5.High-flow oxygen

6.intravenous fluids

The prognosis of Encephalitis is:
This depends on the severity and type of infection.

Viral infections except for herpes simplex usually recover quickly.

Bacterial infections such as meningococcus and pneumonia are more dangerous.

The Preventive measures taken for Encephalitis are:
Vaccinations against Haemophilus influenzae in children and adults has reduced the incidence of this form of meningitis and encephalitis.

Mumps vaccination as part of Measles,mumps and rubella vaccine(MMR) has reduced the incidence of mumps related form of meningitis and encephalitis

Vaccinations against Japanese Encephalitis is given for travelers going to endemic places with Japanese Encephalitis.

Wednesday, May 25, 2011

A Simple Guide to Encephalitis

A Simple Guide to Encephalitis
-----------------------------------

What is Encephalitis?
---------------------------

Encephalitis is a serious medical disease which causes inflammation and infection of the brain.

What are the causes of Encephalitis?
----------------------------------------

The causes of Encephalitis may be divided into:

Infections:
------------
1.viral infections are the most common
(herpes simplex virus, mumps, measles, rubella, chickenpox, West Nile Encephalitis, Japanese Encephalitis, St Lious Encephalitis).

Of these viruses, herpes simplex virus is the most serious and can cause fatality.

2.bacterial infections such as meningoccocus(Neisseria meningitidis) and pneumococcus(Streptococcus pneumoniae) can be serious and fatal in some cases.

Meningococcal Encephalitis can cause outbreaks(spread easily).

3.fungi,
Cryptococcus neoformans is the most common cause of fungal Encephalitis

4.Parasitic
Examples are Toxoplasmosis, malaria, amoeba, Lyme Disease

What are Signs and symptoms of Encephalitis?
---------------------------------------------

The symptoms which often defines Encephalitis are:

1.Severe headache

2.Fever

3.Irritabilty

4.Confusion

5.Drowsiness and fatigue

Other symptoms are:

6.seizures and convulsions

7.vomiting

8.hallucinations

9.memory problems

10.tremors

11.weakness of the hands and legs

12.incontinence of urinary and bowel movement

How is the diagnosis of Encephalitis made?
------------------------------------------

1.Typical symptoms of fever, headache, confusion .

2.Physical examination shows confusion ,drowsiness and signs of neck rigidity

3.blood tests (complete blood count, ESR and blood culture) 

4.cerebrospinal fluid analysis (CSF) via lumbar puncture is examined for increased white blood cells and protein content,  normal glucose level. Red blood cells may be present if there is bleeding. Sometimes the CSF may show the presence of micro-organisms.

This test should not be done if there is suspected cerebral mass lesion or raised intracranial pressure (head injury, localizing neurological signs, or signs of raised ICP).

5.CT or MRI of the brain and spine with MRI preferred over CT because it can detect more easily areas of cerebral edema,tumors, ischemia, and meningeal inflammation.

What are the complications of Encephalitis?
-----------------------------------------------

1.Neurological deficits

2.deafness

3.learning disorders in children

4.brain infarction,

5.septic shock,

6.adult respiratory distress syndrome 

7.seizures also more in children

8.pneumonia especially in the elderly

What is the treatment of Encephalitis?
------------------------------------

1.Hospitalisation should be immediate as Encephalitis is an life threatening condition.

2.Antibiotics such as cephalosporin, ampicillin, chloramphenicol, intravenous vancomycin to be started even before doing lumbar puncture.

Acyclovir may be given for herpes virus infection

High dosages of antifungals may be given for Fungal Encephalitis for a prolonged period of time

3.corticosteroids is useful to reduce swelling and inflammation in the brain

4.Sedatives may be needed for irritabilty and restlessness

5.High-flow oxygen

6.intravenous fluids

What is the prognosis of Encephalitis?
------------------------------------------

This depends on the severity and type of infection.

Viral infections except for herpes simplex usually recover quickly.

Bacterial infections such as meningococcus and pneumonia are more dangerous.

What are the Preventive measures taken for Encephalitis?
--------------------------------------------------------

Vaccinations against Haemophilus influenzae in children and adults has reduced the incidence of this form of meningitis and encephalitis.

Mumps vaccination as part of Measles,mumps and rubella vaccine(MMR) has reduced the incidence of mumps related form of meningitis and encephalitis

Wednesday, November 21, 2007

A Simple Guide to Measles

A Simple Guide to Measles
--------------------------------


What is Measles?
---------------------

Measles is usually a contagious childhood infection caused by the measles virus, one of the paromyxovirus.
It is characterised by typical prodromal symptoms, generalised rash and Koplik's spots in the mouth.

Who is at risk for Measles?
--------------------------------


Any one at any age can contract measles but it usually occurs in childhood.
Spread is usually by infected persons either from mucous discharges from their coughing and sneezing, or from contact with their skin rash,contaminated items and surfaces.
Usually a person is contagious for about two days before symptoms appear, and up to five days after appearance of the rash.


What are the Symptoms of Measles?
-------------------------------------------


There is a prodromal peroid of 5 to 7 days after contact with a infected person.
Early symptoms include:
1.high fever

2.coughing,

3.runny nose, stuffy nose,

4.tiredness,

5.red eyes, tearing. ,

6.Koplik's spots
(white spots with a red background , located on the inside of the cheeks near the back molars start to appear 2-4 days after the fever.

7.measles rash usually occurs after the appearance of the Koplik's spots.
The rash is typically red,maculopapular, and starts from behind the ears and face, then spreads downward to the neck, trunk, limbs, and soles. Once it reaches the soles, the rash begins to fade in about four days , first the head and neck, then trunk and limbs. There may be a brownish discoloration in areas of affected skin rashes but this is only temporary.

8. enlarged lymph glands may be felt in the neck and groins

9.inflammation of the eyes (conjunctivitis) with tearing may also occurs.

10. diarrhoea and vomiting may occurs in some patients.

Adults tend to suffer more severe symptoms than children do.

People who have had measles develop a natural immunity and cannot contract it again.

What are the Complications of Measles?
------------------------------------------------


1.Ear infection (Otitis Media) is a common complication of measles.

2.pneumonia in very young children and older patients may be dangerous.

3.encephalitis (brain infection)may ocur in 1 out of 600 patients putting them at risk of suffering seizures, coma or dying.

4.the digestive organs (including the liver),the heart muscle or the kidneys may be damaged in rare cases

A pregnant woman who develops a measles infection has
1.an increased risk of premature labour,

2.miscarriage


3.delivery of a low birth weight baby.

What is the Treatment for Measles?
------------------------------------------


There is no cure for measles.
Treatment is therefore symptomatic.
Fever symptoms are treated with Paracetamol.
Children should not be given aspirin due to the risk of Reye's Syndrome which affects the brain

Itch may be controlled by antihistamines which can also help to relieve the runny nose.

Antibiotics may be given if there is superimposed secondary bacterial infection such as otitis emdia and pneumonia.

Cough mixtures may be given to relieve the cough.

Plenty of bed rest is necessary.

Lots of fluids helps to prevent dehydration.

A cool-mist humidifier to soothe respiratory passages may help.

Most patients recover completely from measles.


Death is extremely rare (one out of every 1000 cases), usually from pneumonia or encephalitis.

How do You prevent Measles?
-------------------------------------


Measles can be prevented with the measles vaccine, which is usually given to children at the age of 15 months as part of the MMR (measles, mumps and rubella) combination.

A second MMR vaccine is now given at the age of 12 years
.

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