Encephalitis

MCC are HSV and arboviruses

• History / PE:
  AMS, HA, fever, and seizures
• Diagnosis:
  CSF shows lymphocytic pleocytosis
  MRI may show a contrast enhancing lesion in the temporal lobe (HSV)
• Treatment:
  HSV encephalitis requires immediate IV acyclovir
  CMV encephalitis treat with IV ganciclovir +/- foscarnet
  RMSF, lyme disease , ehrichiosis treat with doxyclycline
• Notes:
  Presence of RBCs in CSF without history of trauma indicates HSV