HERPES SIMPLEX VIRUS ENCEPHALITIS

There are mainly two types of herpes simplex viruses,HSV 1,HSV 2,.This most commonly affects the neonates.

 

ASSESSMENT AND DIAGNOSTIC FINDINGS

• History collection and physical examination
• Neuroimaging studies(MRI)
• Electro encephalography
• CSF examination to diagnose HSV encephalitis.
• EEG demonstrates spikes
• Lumbar puncture demonstrates low glucose and high protein levels.
• Polymerase chain reaction(PSR)

CLINICAL MANIFESTATIONS

• HSV-1 virus causes inflammation and necrosis of the temporal lobe.
• Fever,headache and confusion are the initial symptoms.
• Behavioral changes,
• focal seizures,
• dysphasia,
• hemiparesis and
• altered level of consciousness

PATHOPHYSIOLOGY

The olfactory and the trigeminal nerves are the most commonly involved pathways.

MEDICAL MANAGEMENT

• Acyclovir(Zovirax),antiviral agent.To prevent relapse the treatment has to be continued for three weeks,slow IV administration of the drug prevents the crystallization of the drug in the urine.
• Valacyclovir is also given for the treatment of encephalitis.

NURSING MANAGEMENT

• Neurological assessment for monitoring the progression of the disease.
• Comfort measures to reduce headache like dimming the light,reducing the noise and administering the analgesics.
• Opiod analgesics masks the neurological symptoms so it is less preffered.
• If seizures and altered loss of consciousness is present the patient must be protected from injury.

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