What is the clinical presentation of encephalitis?

Updated: Aug 07, 2018
  • Author: David S Howes, MD; Chief Editor: Barry E Brenner, MD, PhD, FACEP  more...
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The clinical presentation and course can be markedly variable. The acuity and severity of the presentation correlate with the prognosis. A history of mosquito or tick bites or exposure to mouse/rat droppings should be sought. Recognizing certain mammalian animal bite(s) associated with rabies or exposure to a bat in an enclosed space for which antirabies treatment was not obtained is very important.

The viral prodrome is typically several days and consists of fever, headache, nausea and vomiting, lethargy, and myalgias. The specific prodrome in encephalitis caused by varicella-zoster virus (VZV), Epstein-Barr virus (EBV), cytomegalovirus (CMV), measles virus, or mumps virus includes rash, lymphadenopathy, hepatosplenomegaly, and parotid enlargement. Dysuria and pyuria are reported with St Louis encephalitis. Extreme lethargy has been noted with West Nile encephalitis (WNE).

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