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Encephalitis During Late Pregnancy

Encephalitis During Late Pregnancy

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  1. Describe briefly the clinical case study.

The clinical case study involves a 25-year aged lady in the thirty-second week of gestation. The woman was found drowsy with a bitten tongue. Some few days prior to the incidence, she had frontotemporal headache associated with photophobia and phonophobia and a fever of 39 degrees Celsius, nausea and vomiting (Sellner et al., 2009). On the day her condition deteriorated, she had anterograde and retrograde amnesia. Her blood pressure was normal, and no somatic neurological deficit was found. Doctors had to conduct a series of tests to identify the health problem and diagnosed acute viral encephalitis. Nevertheless, the woman gave birth to a healthy infant that was put on acyclovir prophylaxis to prevent the possible transfer of the illness from the mother to the newborn.

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  1. Describe the clinical hallmark of acute viral encephalitis.

According to Sellner et al. (2009), the hallmark of acute viral encephalitis entails a triad of fever, altered mental state and headache, and these are the signs that doctors should mostly consider. Apart from them, other minor manifestations include disorientation, speech and behavioral disturbances, as well as diffuse or focal neurological signs, such as hemiparesis or seizure.

  1. Identify the most common cause of neonatal herpes infection.

The most commn cause of the neonatal herpes infection is the herpes simplex virus type 2, which causes 85% of the infections. According to Sellner et al. (2009), the virus is contracted from herpetic lesions in the genital track during normal vaginal delivery in case of the uterine infection. An infant may therefore contract the disease while in the uterus or in the process of birth. However, the primary infection with the herpes simplex virus type 1 is also a contributor to the problem.

  1. Describe the best radiologic test for detecting viral encephalitis.

According to Sellner et al. (2009), the best radiological test for detecting viral encephalitis is the MRI scan. It entails gadolinium-enhanced MRI that facilitates the visualization of lesions, diffusion-weighted MRI that differentiates cytotoxic and vasogenic edema, as well as brain MRI that helps to monitor lesion evolution and possible cerebral complications.

  1. Describe the diagnostic test of choice for detecting herpes simplex virus encephalitis.

One of the diagnostic tests for detecting herpes simplex virus encephalitis is the polymerase chain reaction that is conducted on patient’s cerebro-spinal fluid (Sellner et al., 2009). The test for both herpes simplex types 1 and 2 respectively may be positive implying the presence of the respective virus. If the results of the test are negative, then the latter is absent in the patient’s body.

  1. Why is it important to perform a differential diagnosis for acute encephalitis?

According to Sellner et al. (2009), a differential diagnosis is crucial because infectious diseases of the central nervous system also have such symptoms as headache, fever, and nausea. It is therefore important to differentiate the infections from acute encephalitis, and because the latter has no specific characteristics that distinguish it from the former, a differential diagnosis is necessary. It is crucial for diseases that have clashing symptoms, since there is a need to determine a real illness and avoid treating the wrong one.

  1. What are the best treatment and prevention strategies to deal with acute encephalitis to get a favorable outcome?

According to Sellner et al. (2009), the widely accepted treatment of acute encephalitis in adults is an intravenous injection of acyclovir in the amounts of 10mg/kg every eight hours. However, the dose may be increased depending on the patient’s condition. In adults, treatment lasts for 14 days if the immune system functions properly, but in case it is suppressed, treatment may be extended to 21 days. For neonates, 20mg/kg every eight hours is appropriate and should last for 21 days because their level of immunity is lower as compared to that of adults. Acyclovir prophylaxis is an effective prevention strategy for infants whose condition may is satisfactory after birth.  

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