What is the initial management for suspected herpes simplex encephalitis (HSE)?

Updated: Jul 17, 2018
  • Author: Wayne E Anderson, DO, FAHS, FAAN; Chief Editor: Niranjan N Singh, MBBS, MD, DM, FAHS, FAANEM  more...
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Answer

Prehospital care consists of supportive management of the patient’s airway, breathing, and circulation (ABCs). General nutritional and fluid support is important. Universal precautions are appropriate. Monitor for increased intracranial pressure (ICP) and seizures.

Intensive care unit (ICU) care may be required, especially if seizure activity or increased ICP is present. Depending on the availability of local expertise (eg, infectious disease, neurology, neurosurgery specialists), transfer to a tertiary care facility may be appropriate. Hospitalization is not routine for uncomplicated herpes simplex virus type 1 (HSV-1) or herpes simplex virus type 2 (HSV-2) infection.


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