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Viral Encephalitis - #PHARMFAX

Acyclovir reduced mortality from herpes simplex encephalitis from 70% to 9%. Thats pretty good.

 


The introduction of acyclovir reduced mortality from herpes simplex encephalitis from 70% to 9%. Thats pretty good. Viral encephalitis is commonly associated with seizures, altered mental status, and fevers. Diagnostics will include imaging and a lumbar puncture.


Common CSF viral findings are normal or elevated opening pressure and proteins, normal glucose, and lymphocyte predominance. Herpes simplex and Varicella Zoster are common viral etiologies, and CSF assays can detect other causative pathogens.


Acyclovir will be our antiviral of choice. It is often given empirically with antibiotics pending further testing. We'll give 10 mg/kg of AdjBW IV every 8 hours. Acyclovir may accumulate in the distal tubular lumen and precipitate, leading to obstructions. Acute kidney injury can be seen within 48 hours post initation.


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ESETT Secondary Anticonvulsants: https://www.instagram.com/reel/CpOgF9kJpwM/


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