Viral encephalitis and bacterial encephalitis differences

Written by Zhang Hui
Neurology
Updated on September 01, 2024
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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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Written by Zhang Hui
Neurology
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Does encephalitis require hospitalization?

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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Written by Li Jiao Yan
Neonatology
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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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Written by Tang Li Li
Neurology
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Can encephalitis recur?

Encephalitis comes in various types, some of which are prone to recurrence, while others are monophasic and do not recur. The most common type is viral encephalitis, particularly infections caused by the herpes simplex virus. Although recovery from viral encephalitis after antiviral treatment is possible, it may leave some sequelae, but generally does not recur. Tuberculous meningoencephalitis, however, has a higher rate of recurrence, often related to the resistance of tuberculosis bacteria and inadequate anti-tuberculosis treatment. Patients need repeated lumbar puncture tests to confirm that the cerebrospinal fluid has returned to normal levels and require long-term use of anti-tuberculosis medications. Bacterial meningitis generally does not recur. Additionally, there are some autoimmune types of encephalitis, such as autoimmune encephalitis, multiple sclerosis, and neuromyelitis optica, where recurrence is possible when involving the brain.

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Written by Tang Li Li
Neurology
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Is the blood count high in encephalitis?

Not all cases of encephalitis show an increase in blood counts. Elevated blood counts in encephalitis generally occur in bacterial infections, such as the most common pyogenic meningitis. This can cause a significant increase in blood counts, predominantly with neutrophils. Tuberculous meningitis can also show elevated blood counts, but not as prominently as pyogenic meningitis. In cases of viral infection, such as the common herpes simplex virus infection, patients might experience a decrease in blood counts. This is characterized by a reduction in the total number of white blood cells, a lower proportion of neutrophils, and a possible increase in lymphocyte proportion. If the patient has a concurrent lung infection or other bacterial infections at different sites, there might be an increase in blood counts, which can mask the blood abnormalities originally caused by the viral infection.

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Written by Zhang Hui
Neurology
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Does encephalitis cause a runny nose?

Encephalitis can potentially cause a runny nose, as it is mainly caused by viral infections. These infections not only invade brain cells, leading to symptoms such as fever, headache, nausea, vomiting, and even seizures related to the nervous system, but can also affect the respiratory tract. If these viruses accumulate in the respiratory tract, particularly in the nasal mucosa, they will definitely cause symptoms such as a runny nose, cough, expectoration, and sore throat. Therefore, it is evident that patients with encephalitis can exhibit symptoms of upper respiratory tract infections. Moreover, some patients initially present with respiratory symptoms, such as a runny nose, before the viruses enter and infect the brain cells. Patients with encephalitis must receive timely treatment, primarily symptomatic treatment to prevent complications, along with antiviral medication for targeted treatment. Most patients have a good prognosis.