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Cited by 1,193Infectious Encephalopathies and EncephalitisBacterial Infections and VaccinesInfectious Diseases and Tuberculosis

The Management of Encephalitis: Clinical Practice Guidelines by the Infectious Diseases Society of America

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Tunkel, Allan R., Glaser, Carol A., Bloch, Karen C., Sejvar, James J., Marra, Christina M., Roos, Karen L., Hartman, Barry J., Kaplan, Sheldon L. +2 more·2008·Clinical Infectious Diseases
DOI 10.1086/589747
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Abstract

Guidelines for the diagnosis and treatment of patients with encephalitis were prepared by an Expert Panel of the Infectious Diseases Society of America. The guidelines are intended for use by health care providers who care for patients with encephalitis. The guideline includes data on the epidemiology, clinical features, diagnosis, and treatment of many viral, bacterial, fungal, protozoal, and helminthic etiologies of encephalitis and provides information on when specific etiologic agents should be considered in individual patients with encephalitis.

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  • Results from the largest RCT included in the meta-analysis (a comparison of sustained courses of moxifloxacin and meropenem vs meropenem alone in a low endemic resistance setting) were consistent with the findings from the meta-analysis.

    “Results from the largest RCT included in the meta-analysis (a comparison of sustained courses of moxifloxacin and meropenem vs meropenem alone in a low endemic resistance setting) were consistent with the findings from the metaanalysis ( 161).”

    From Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock 2021. (2021) · cites this paper as [161]

    The supplied passages discuss encephalitis treatments, including fluoroquinolone recommendations in sections 41 and 47, but do not discuss the claimed trial. Searches for moxifloxacin, meropenem, the largest RCT, and low endemic resistance found no passage addressing the trial or its consistency with a meta-analysis. (LLM, conf=0.78)

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  1. Johnson RT. Acute encephalitis. Clin Infect Dis 1996; 23:219-24; quiz 225-6.
  2. Canadian Task Force on the Periodic Health Examination. The pe- riodic health examination. Can Med Assoc J 1979; 121:1193-254.
  3. Scheld WM, Whitley RJ, Marra CM, eds. Infections of the central nervous system. 3rd ed. Philadelphia: Lippincott Williams & Wilkins, 2004.
  4. Whitley RJ, Gnann JW. Viral encephalitis: familiar infections and emerging pathogens. Lancet 2002; 359:507-14.
  5. Romero JR, Newland JG. Viral meningitis and encephalitis: traditional and emerging viral agents. Semin Pediatr Infect Dis 2003; 14:72-82.
  6. McCarthy M. Newer viral encephalitides. Neurologist 2003; 9:189-99.
  7. Solomon T. Exotic and emerging viral encephalitides. Curr Opin Neu- rol 2003; 16:411-8.
  8. Kennedy PGE. Viral encephalitis: causes, differential diagnosis, and management. J Neurol Neurosurg Psychiatry 2004; 75:10-5.
  9. Solomon T. Flavivirus encephalitis. N Engl J Med 2004; 351:370-8.
  10. Sejvar JJ. The evolving epidemiology of viral encephalitis. Curr Opin Neurol 2006; 19:350-7.
  11. Glaser CS, Gilliam S, Schnurr D, et al. In search of encephalitis eti- ologies: diagnostic challenges in the California Encephalitis Project, 1998-2000. Clin Infect Dis 2003; 36:731-42.
  12. Glaser CS, Honarmand S, Anderson LJ, et al. Beyond viruses: clinical profiles and etiologies associated with encephalitis. Clin Infect Dis 2006; 43:1565-77.
  13. Leiby DA, Gill JE. Transfusion-transmitted tick-borne infections: a cornucopia of threats. Transfus Med Rev 2004; 18:293-306.
  14. Arribas JR, Storch GA, Clifford DB, Tselis AC. Cytomegalovirus en- cephalitis. Ann Intern Med 1996; 125:577-87.
  15. Miller GG, Boivin G, Dummer JS, et al. Cytomegalovirus ventricu- loencephalitis in a peripheral blood stem cell transplant recipient. Clin Infect Dis 2006; 42:e26-9.
  16. Zerr DM, Corey L, Kim HW, et al. Clinical outcomes of human herpesvirus 6 reactivation after hematopoietic stem cell transplanta- tion. Clin Infect Dis 2005; 40:932-40.
  17. Kleinschmidt-DeMasters BK, Marder BA, Levi ME, et al. Naturally acquired West Nile virus encephalomyelitis in transplant recipients. Arch Neurol 2004; 61:1210-20.
  18. Ravindra KV, Freifeld AG, Kalil AC, et al. West Nile virus-associated encephalitis in recipients of renal and pancreas transplants: case series and literature review. Clin Infect Dis 2004; 38:1257-60.
  19. Bode AV, Sejvar JJ, Pape J, et al. West Nile virus disease: a descriptive study of 228 patients hospitalized in a 4-county region of Colorado in 2003. Clin Infect Dis 2006; 42:1234-40.
  20. Hankins DG, Rosekrans JA. Overview, prevention, and treatment of rabies. Mayo Clin Proc 2004; 79:671-6.
  21. Srinivasan A, Burton EC, Kuehnert MJ, et al. Transmission of rabies virus from an organ donor to four transplant recipients. N Engl J Med 2005; 352:1103-11.
  22. Perry RT, Halsey NA. The clinical significance of measles: a review. J Infect Dis 2004; 189(Suppl 1):S4-16.
  23. Hsu VP, Hossain MJ, Parashar UD, et al. Nipah virus encephalitis reemergence, Bangladesh. Emerg Infect Dis 2004; 10:2082-7.
  24. Newland JG, Romero JR, Varman M, et al. Encephalitis associated with influenza B virus infection in 2 children and a review of the literature. Clin Infect Dis 2003; 36:e87-95.
  25. Bitnun A, Ford-Jones E, Blaser S, Richardson S. Mycoplasma pneu- moniae encephalitis. Semin Pediatr Infect Dis 2003; 14:96-107.
  26. Daxboeck F. Mycoplasma pneumoniae central nervous system infec- tions. Curr Opin Neurol 2006; 19:374-8.
  27. Christie LJ, Honarmand S, Talkington DF, et al. Pediatric encephalitis: what is the role of Mycoplasma pneumoniae? Pediatrics 2007; 120: 305-13.
  28. Lugassy MM, Louis ED. Neurologic manifestions of Whipple's disease. Curr Infect Dis Rep 2006; 8:301-6.
  29. Gerard A, Sarrot-Reynauld F, Liozon E, et al. Neurologic presentation of Whipple's disease: report of 12 cases and review of the literature. Medicine 2002; 81:443-57.
  30. Walker M, Kublin JG, Zunt JR. Parasitic central nervous system in- fection in immunocompromised hosts: malaria, microsporidiosis, leis- maniasis, and African trypanosomiasis. Clin Infect Dis 2006; 42: 115-25.
  31. Perez MT, Bush LM. Balamuthia mandrillaris amebic encephalitis. Curr Infect Dis Rep 2007; 9:323-8.
  32. Murray WJ, Kazacos KR. Raccoon roundworm encephalitis. Clin In- fect Dis 2004; 39:1484-92.
  33. Gavin PJ, Kazacos KR, Shulman ST. Baylisascariasis. Clin Microbiol Rev 2005; 18:703-18.
  34. Shafir SC, Wise ME, Sorvillo FJ, Ash LR. Central nervous system and eye manifestations of infection with Baylisascaris procyonis. Curr Infect Dis Rep 2006; 8:307-13.
  35. Dale R. Acute disseminated encephalomyelitis. Semin Pediatr Infect Dis 2003; 14:90-5.
  36. Leake JA, Albani S, Kao AS, et al. Acute disseminated encephalo- myelitis in childhood: epidemiologic, clinical, and laboratory features. Pediatr Infect Dis J 2004; 23:756-65.
  37. Bennetto L, Scolding N. Inflammatory/post-infectious encephalo- myelitis. J Neurol Neurosurg Psychiatry 2004; 75:22-8.
  38. Leite C, Barbosa A, Lucato LT. Viral diseases of the central nervous system. Top Magn Reson Imaging 2005; 16:189-212.
  39. Steiner I, Budka H, Chaudhuri A, et al. Viral encephalitis: a review of diagnostic methods and guidelines for management. Eur J Neurol 2005; 12:33-43.
  40. Romero JR, Newland JG. Diagnosis of viral encephalitides: nonzoon- otic-associated viruses. Pediatr Infect Dis J 2006; 25:739-40.
  41. Romero JR, Newland JG. Diagnosis of viral encephalitides: zoonotic- associated viruses. Pediatr Infect Dis J 2006; 25:741-2.
  42. Bloch KC, Glaser CA. Diagnostic approaches for patients with sus- pected encephalitis. Curr Infect Dis Rep 2007; 9:315-22.
  43. Schuster FL, Honarmand S, Visvesvara GS, Glaser CA. Detection of antibodies against free-living amoebae Balamuthia mandrillaris and Acanthamoeba species in a population of patients with encephalitis. Clin Infect Dis 2006; 42:1260-5.
  44. Hemachudha T, Wacharapluesadee S. Antemortem diagnosis of hu- man rabies. Clin Infect Dis 2004; 39:1085-6.
  45. Nagaraj T, Vasanth JP, Desaia A, et al. Ante mortem diagnosis of human rabies using saliva samples: comparison of real time and con- ventional RT-PCR techniques. J Clin Virol 2006; 36:17-23.
  46. Everett ED, Evans KA, Henry RB, et al. Human ehrlichiosis in adults after tick exposure: diagnosis using polymerase chain reaction. Ann Intern Med 1994; 120:730-5.
  47. Olano JP, Masters E, Hogrefe W, et al. Human monocytotrophic ehrlichiosis, Missouri. Emerg Infect Dis 2003; 9:1579-86.
  48. Horowitz HW, Aguero-Rosenfeld ME, McKenna DF, et al. The clinical and laboratory spectrum of culture proven human granulocytic ehr- lichiosis: comparison with culture negative cases. Clin Infect Dis 1998; 27:1314-7.
  49. Hansmann Y, DeMartino S, Piemont Y, et al. Diagnosis of cat scratch disease with detection of Bartonella henselae by PCR: a study of pa- tients with lymph node enlargement. J Clin Microbiol 2005; 43: 3800-6.
  50. Maschke M, Kastrup O, Forsting M, Diener HC. Update of neuroim- aging in infectious central nervous system disease. Curr Opin Neurol 2004; 17:475-80.
  51. Domingues RB, Fink MC, Tsanaclis AMC, et al. Diagnosis of herpes simplex encephalitis by magnetic resonance imaging and polymerase chain reaction assay of cerebrospinal fluid. J Neurol Sci 1998; 157: 148-53.
  52. Lee BY, Newberg AB, Liebeskind DS, et al. FDG-PET findings in patients with suspected encephalitis. Clin Nucl Med 2004; 29:620-5.
  53. Whitley RJ, Tilles J, Linneman C, et al. Herpes simplex encephalitis: clinical assessment. JAMA 1982; 247:317-20.
  54. Cinque P, Bossolasco S, Lundkvist A. Molecular analysis of cerebro- spinal fluid in viral diseases of the central nervous system. J Clin Virol 2003; 26:1-28.
  55. DeBiasi RL, Tyler KL. Molecular methods for diagnosis of viral en- cephalitis. Clin Microbiol Rev 2004; 17:903-25.
  56. Huang C, Morse D, Slater B, et al. Multiple-year experience in the diagnosis of viral central nervous system infections with a panel of polymerase chain reaction assays for detection of 11 viruses. Clin Infect Dis 2004; 39:630-5.
  57. Boriskin YS, Rice PS, Stabler RA, et al. DNA microarrays for virus detection in cases of central nervous system infection. J Clin Microbiol 2004; 42:5811-8.
  58. Tyler KL. Update on herpes simplex encephalitis. Rev Neurol Dis 2004; 1:169-78.
  59. Kimberlin DEW, Lakeman FD, Arvin AM, et al. Application of the polymerase chain reaction to the diagnosis and management of neo- natal herpes simplex virus disease. J Infect Dis 1996; 174:1162-7.
  60. Weil AA, Glaser CA, Amad Z, Forghani B. Patients with suspected herpes simplex encephalitis: rethinking an initial negative polymerase chain reaction result. Clin Infect Dis 2002; 34:1154-7.
  61. Elbers JM, Bitnun A, Richardson SE, et al. A 12-year prospective study of childhood herpes simplex encephalitis: is there a broader spectrum of disease? Pediatrics 2007; 119:e399-407.
  62. De Tiege X, Heron B, Lebon P, et al. Limits of early diagnosis of herpes simplex encephalitis in children: a retrospective study of 38 cases. Clin Infect Dis 2003; 36:1335-9.
  63. Bossolasco S, Calori G, Moretti F, et al. Prognostic significance of JC virus DNA levels in cerebrospinal fluid of patients with HIV-associated progressive multifocal leukoencephalopathy. Clin Infect Dis 2005; 40: 738-44.
  64. Bitnun A, Ford-Jones EL, Petric M, et al. Acute childhood encephalitis and Mycoplasma pneumoniae. Clin Infect Dis 2001; 32:1674-84.
  65. Polage CR, Petti CA. Assessment of the utility of viral culture of cerebrospinal fluid. Clin Infect Dis 2006; 43:1578-9.
  66. Whitley RJ, Cobbs CG, Alford CA Jr, et al. Diseases that mimic herpes simplex encephalitis: diagnosis, presentation and outcome. JAMA 1989; 262:234-9.
  67. Halperin JJ, Shapiro ED, Logigian E, et al. Practice parameter: treat- ment of nervous system Lyme disease (an evidence-based review). Report of the Quality Standards Subcommittee of the American Acad- emy of Neurology. Neurology 2007; 69:91-102.
  68. Marconi VC, Garcia HH, Katz JT. Neurocysticercosis. Curr Infect Dis Rep 2006; 8:293-300.
  69. Johnson RH, Einstein HE. Coccidioidal meningitis. Clin Infect Dis 2006; 42:103-7.
  70. Williams PL. Coccidioidal meningitis. Ann NY Acad Sci 2007; 1111: 377-84.
  71. Schmid C, Nkunku S, Merolle A, et al. Efficacy of 10-day melarsoprol schedule 2 years after treatment for late-stage gambiense sleeping sickness. Lancet 2004; 364:789-90.
  72. Wang A, Kay R, Poon WS, Ng HK. Successful treatment of amoebic meningoencephalitis in a Chinese living in Hong Kong. Clin Neurol Neurosurg 1993; 95:249-52.
  73. Jain R. Naegleria meningitis: a rare survival. Neurol India 2002; 50: 470-2.
  74. Barnett ND, Kaplan AM, Hopkin RJ, et al. Primary amoebic menin- goencephalitis with Naegleria fowleri: clinical review. Pediatr Neurol 1996; 15:230-4.
  75. Visvesvara GS, Moura H, Schuster FL. Pathogenic and opportunistic free-living amoebae: Acanthamoeba spp., Balamuthis mandrillaris, Naegleria fowleri, and Sappinia diploidea. FEMS Immunol Med Mi- crobiol 2007; 50:1-26.
  76. Deetz TR, Sawyer MH, Billman G, et al. Successful treatment of Balamuthia amoebic encephalitis: presentation of 2 cases. Clin Infect Dis 2003; 37:1304-12.
  77. Griffith KS, Lewis LS, Mali S, Parise ME. Treatment of malaria in the United States: a systematic review. JAMA 2007; 297:2264-77.
  78. Warrell DA, Looareesuwan S, Warrell MJ, et al. Dexamethasone proves deleterious in cerebral malaria: a double-blind trial in 100 comatose patients. N Engl J Med 1982; 306:313-9.
  79. Hoffman SL, Rastama D, Punjabi NH, et al. High-dose dexametha- sone in quinine-treated patients with cerebral malaria: a double-blind placebo-controlled trial. J Infect Dis 1988; 158:325-31.
  80. Riddle MS, Jackson JL, Sanders JW, Blazes DL. Exchange transfusion as an adjunct therapy in severe Plasmodium falciparum malaria: a meta-analysis. Clin Infect Dis 2002; 34:1192-8.
  81. Pai PJ, Blackburn BG, Kazacos KR, et al. Full recovery from Baylis- ascaris procyonis eosinophilic meningitis. Emerg Infect Dis 2007; 13: 928-30.
  82. Whitley RJ, Kimberlin DW. Herpes simplex encephalitis in children and adolescents. Semin Pediatr Infect Dis 2005; 16:17-23.
  83. Ito Y, Kimura H, Yabuta Y, et al. Exacerbation of herpes simplex encephalitis after successful treatment with acyclovir. Clin Infect Dis 2000; 30:185-7.
  84. Raschilas F, Wolff M, Delatour F, et al. Outcome of and prognostic factors for herpes simplex encephalitis in adult patients: results of a multicenter study. Clin Infect Dis 2002; 35:254-60.
  85. Whitley RJ. Neonatal herpes simplex virus infection. Curr Opin Infect Dis 2004; 17:243-6.
  86. Valencia I, Miles DK, Melvin J, et al. Relapse of herpes encephalitis after acyclovir therapy: report of two new cases and review of the literature. Neuropediatrics 2004; 35:371-6.
  87. Kamei S, Sekizawa T, Shiota H, et al. Evaluation of combination therapy using aciclovir and corticosteroid in adult patients with herpes simplex virus encephalitis. J Neurol Neurosurg Psychiatry 2005; 76: 1544-9.
  88. Poscher ME. Successful treatment of varicella zoster meningoen- cephalitis in patients with AIDS. AIDS 1994; 8:1115-7.
  89. Anduze-Faris BM, Fillet AM, Gozlan J, et al. Induction and main- tenance therapy of cytomegalovirus central nervous system infection in HIV-infected patients. AIDS 2000; 14:517-24.

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Authors
Tunkel, A. R., Glaser, C. A., Bloch, K. C., Sejvar, J. J., Marra, C. M., Roos, K. L., Hartman, B. J., Kaplan, S. L., Scheld, W. M., & Whitley, R. J.
Affiliations
  • Monmouth Medical Center (US)
  • California Health and Human Services Agency (US)
  • Vanderbilt University (US)
  • Centers for Disease Control and Prevention (US)
  • University of Washington (US)
  • Indiana University School of Medicine (US)
  • Weill Cornell Medical Center (US)
  • Baylor College of Medicine (US)
  • University of Virginia (US)
  • University of Alabama at Birmingham (US)
Corresponding author
Tunkel, Allan R.
ORCID
Venue
Clinical Infectious Diseases
Publisher
Oxford University Press (OUP)
Published
2008-08-01
Volume
47
Issue
3
Pages
303-327
ISSN
  • 1058-4838 (ISSN-L)
  • 1537-6591
DOI
10.1086/589747
OpenAlex
W2123461911
Cited by
1,193
References
2
Citations by year
2026: 68 · 2025: 84 · 2024: 85 · 2023: 74 · 2022: 77 · 2021: 79 · 2020: 80 · 2019: 73 · 2018: 61 · 2017: 75 · 2016: 76 · 2015: 58 · 2014: 69 · 2013: 65 · 2012: 54
FWCI
24.13
Type
journal article
Language
en
Open access
Locations
  • Clinical Infectious Diseases (publishedVersion)
  • PubMed (publishedVersion)
Funders
  • Pfizer
  • Sanofi
Topics
  • Health Sciences › Medicine › Infectious Diseases › Infectious Encephalopathies and Encephalitis
  • Life Sciences › Immunology and Microbiology › Microbiology › Bacterial Infections and Vaccines
  • Health Sciences › Medicine › Surgery › Infectious Diseases and Tuberculosis
Keywords
encephalitis, viral encephalitis, bacterial encephalitis, fungal encephalitis, etiology, diagnosis, treatment, clinical features
MeSH terms
Anti-Infective Agents, Encephalitis, Humans, Evidence-Based Medicine

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