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West Nile Encephalitis Treatment & Management

  • Author: Burke A Cunha, MD; Chief Editor: Michael Stuart Bronze, MD  more...
 
Updated: Oct 22, 2015
 

Approach Considerations

Provide supportive care to minimize the potential for cerebral edema. In comatose patients, pay special attention to maintaining a clear airway.

Replace fluids and electrolytes, as they are lost through insensible losses due to fever and decreased or absent intake. Patients who are unconscious may need ventilation support in an intensive care unit (ICU) until consciousness is restored.

A normal diet and normal activity, as tolerated by the patient, are acceptable. Many patients recover quickly, but some experience prolonged malaise.[14, 15, 16]

No proven benefit has been observed in small numbers of patients treated with interferon, ribavirin, or intravenous immunoglobulin (IVIG).

West Nile encephalopathy (WNE) is prevented through avoidance of mosquitoes.

Consult an infectious disease specialist and a neurologist. In patients with WNE, repeat testing for relative lymphopenia or increased serum transaminases until levels return to normal. A repeat lumbar puncture is usually unnecessary. Further outpatient care is usually unnecessary.

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Deterrence/Prevention

No vaccine is currently commercially available. Preventive strategies focus on mosquito avoidance.

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Contributor Information and Disclosures
Author

Burke A Cunha, MD Professor of Medicine, State University of New York School of Medicine at Stony Brook; Chief, Infectious Disease Division, Winthrop-University Hospital

Burke A Cunha, MD is a member of the following medical societies: American College of Chest Physicians, American College of Physicians, Infectious Diseases Society of America

Disclosure: Nothing to disclose.

Specialty Editor Board

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Received salary from Medscape for employment. for: Medscape.

John L Brusch, MD, FACP Assistant Professor of Medicine, Harvard Medical School; Consulting Staff, Department of Medicine and Infectious Disease Service, Cambridge Health Alliance

John L Brusch, MD, FACP is a member of the following medical societies: American College of Physicians, Infectious Diseases Society of America

Disclosure: Nothing to disclose.

Chief Editor

Michael Stuart Bronze, MD David Ross Boyd Professor and Chairman, Department of Medicine, Stewart G Wolf Endowed Chair in Internal Medicine, Department of Medicine, University of Oklahoma Health Science Center; Master of the American College of Physicians; Fellow, Infectious Diseases Society of America

Michael Stuart Bronze, MD is a member of the following medical societies: Alpha Omega Alpha, American Medical Association, Oklahoma State Medical Association, Southern Society for Clinical Investigation, Association of Professors of Medicine, American College of Physicians, Infectious Diseases Society of America

Disclosure: Nothing to disclose.

Acknowledgements

Wesley W Emmons, MD, FACP Assistant Professor, Department of Medicine, Thomas Jefferson University; Consulting Staff, Infectious Diseases Section, Department of Internal Medicine, Christiana Care, Newark, DE

Wesley W Emmons, MD, FACP is a member of the following medical societies: American College of Physicians, American Medical Association, American Society of Tropical Medicine and Hygiene, Infectious Diseases Society of America, and International AIDS Society

Disclosure: Nothing to disclose.

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Common encephalitis associations.
Clinical features of arboviral encephalitis.
Differential diagnoses of meningoencephalitis.
The Culex mosquito, common in the eastern United States, is the primary vector responsible for infecting humans with West Nile virus. Prevention of West Nile virus is primarily directed at reducing the mosquito population from May to October and by taking precautions to limit human exposure during these months of high mosquito activity. Image courtesy of the Centers for Disease Control and Prevention.
The geographic distribution of the Japanese encephalitis servocomplex of the family Flaviridae, 2000. Image courtesy of the Centers for Disease Control and Prevention.
States reporting laboratory-positive West Nile virus infection in birds, mosquitoes, animals, or humans between January 1 and August 28, 2002. Image courtesy of the Centers for Disease Control and Prevention.
 
 
 
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