Does encephalitis require hospitalization?

Written by Zhang Hui

Neurology

Updated on September 24, 2024

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The severity of encephalitis can vary greatly; it is generally caused by viral infection. Among these viruses, Herpes Simplex Virus (HSV) is particularly dangerous. Encephalitis caused by HSV can be very severe, with symptoms including high fever, headache, nausea, vomiting, and other serious manifestations. Some patients may even experience seizures, coma, cognitive decline, and changes in mood and behavior. This type of encephalitis is very severe and definitely requires hospitalization. Typically, hospitalization lasts about 2 to 3 weeks, and proper antiviral treatment is necessary. Additionally, there are other forms of encephalitis caused by different viruses that are relatively milder and may even have a certain degree of self-healing properties. Generally, resting well, drinking plenty of water, and consuming fresh vegetables and fruits can lead to recovery. Therefore, whether hospitalization is necessary for encephalitis depends on the severity of the condition and the assessment of which virus has caused the infection. It cannot be generalized.

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How is encephalitis in children treated?

Encephalitis in children is generally treated based on the cause of the infection. It could be caused by viral infections, bacterial infections, or other pathogens. The most basic treatment is definitely to address the cause of the encephalitis. If there are other symptoms such as fever or seizures, symptomatic treatment should be administered based on these symptoms. The treatment plan should be tailored to the specific condition of the child.

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Viral encephalitis and bacterial encephalitis differences

There are significant differences between viral encephalitis and bacterial encephalitis in clinical settings. Firstly, their clinical symptoms differ; the fever in viral encephalitis is generally lower than that in bacterial encephalitis, where there may be widespread chills and persistent high fever. From another perspective, laboratory tests also help differentiate the two. In viral encephalitis, a routine blood test shows no increase in white blood cells, mainly an increase in the proportion of lymphocytes. In contrast, bacterial encephalitis is characterized by a significant increase in white blood cells, which aids in distinguishing the two. Furthermore, an essential diagnostic tool is the lumbar puncture, through which cerebrospinal fluid can be tested. In viral encephalitis, the white blood cell count in the cerebrospinal fluid is slightly increased; in bacterial encephalitis, it is significantly increased. The cerebrospinal fluid in viral encephalitis has a slight increase in protein content with no significant change in chloride levels; however, in bacterial encephalitis, the protein content in the cerebrospinal fluid is notably higher, and there is a significant decrease in chloride levels.

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Pediatric Encephalitis Examination Items

Encephalitis in children is primarily due to a lowered immune resistance, which leads to infection by certain viruses. These viruses invade the nervous system, causing damage to neurons, resulting in symptoms such as fever, headache, nausea, and vomiting. Generally, the main tests for pediatric encephalitis include hematological tests related to bleeding, primarily involving routine blood tests, C-reactive protein, and erythrocyte sedimentation rate. These indices can reflect the inflammatory conditions inside the patient's body, helping to distinguish between viral and bacterial infections. Another very important auxiliary examination is the electroencephalogram (EEG), where pediatric encephalitis can show mild to moderate abnormalities, which is helpful for accurate diagnosis. The third examination involves performing a lumbar puncture to test the cerebrospinal fluid (CSF) for the levels of white cells, glucose, and chloride, which are crucial for diagnosing encephalitis and differentiating it from other types of encephalitis.

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Neurology

54sec

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Encephalitis belongs to which department?

Encephalitis is primarily a neurological disorder and is an infectious disease of the central nervous system, mainly diagnosed and treated in neurology. There are many causes of encephalitis, with viral encephalitis being the most common. For example, herpes simplex encephalitis is a typical type seen clinically. Patients may experience fever, even with very high temperatures exceeding 40°C, headaches, nausea, and vomiting. If the condition worsens, seizures, coma, and cognitive impairment may occur. These clinical manifestations require further investigations like electroencephalography, cranial MRI, and lumbar puncture. Additionally, there is a specific type of epidemic, known as Japanese encephalitis, which falls under the category of infectious diseases due to its contagious nature.

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Neurology

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What tests are done for pediatric encephalitis?

Some auxiliary examinations are very necessary for pediatric encephalitis, which help in the diagnosis and differential diagnosis of encephalitis. The main tests generally include the following: First, an electroencephalogram (EEG), which is the most commonly used examination. It is safe, non-invasive, and relatively accurate. Children with encephalitis will show light to moderate abnormalities in the EEG. Combined with the patient's history of fever and headache, it has important clinical significance for the diagnosis of encephalitis. The second important examination is cranial magnetic resonance imaging (MRI). If the encephalitis is severe, pathological changes in the cerebrospinal fluid can be seen on MRI. The third very important examination is lumbar puncture. Lumbar puncture can mainly determine the pressure of the cerebrospinal fluid, the color of the cerebrospinal fluid, and analyze the levels of white blood cells, glucose, and chloride in the cerebrospinal fluid. This is crucial for diagnosing encephalitis and excluding other types of encephalitis.