Encephalitis is a topic covered in the Washington Manual of Medical Therapeutics.

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General Principles

  • Encephalitis is inflammation of the brain parenchyma, usually due to viral infections.
  • HSV-1 is the most common and most important cause of sporadic infectious encephalitis. Other causes include arboviruses such as West Nile virus (WNV), enteroviruses, other herpesviruses, and rabies.
  • Nonviral causes include Mycobacterium tuberculosis, syphilis, fungi, Mycoplasma pneumoniae, and Bartonella henselae. In the summer months, tick-borne illness (e.g., Ehrlichia, Rocky Mountain spotted fever [RMSF] and Lyme disease) should be considered.
  • Noninfectious causes include vasculitis, collagen vascular disease, paraneoplastic syndromes, and acute disseminated encephalomyelitis, which can occur after an infection or immunization.

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