How is encephalopathy due to systemic illnesses differentiated from West Nile virus (WNV) infection and encephalitis (WNE)?

Updated: Apr 05, 2021
  • Author: David J Cennimo, MD, FAAP, FACP, AAHIVS; Chief Editor: Michael Stuart Bronze, MD  more...
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Answer

Encephalopathy is a feature of many systemic illnesses that the clinician should consider in patients presenting with encephalitis. Most of these patients have extra-CNS findings that suggest the underlying disease process. Common disorders with CNS manifestations that may mimic WNE include subacute bacterial endocarditis, Legionnaires disease, Rocky Mountain spotted fever, Epstein-Barr virus infectious mononucleosis, human herpesvirus type 6 (HHV-6) infection, and systemic lupus erythematosus cerebritis. Other noninfectious causes of encephalopathy to consider initially may include uremia, hyperammonemia, intoxication or ingestion, or other metabolic derangement.


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