Viral encephalitis
Antimicrobial prescribing: NHS Fife
Warning
Clinical features
Febrile illness (> 85% of patients) plus at least one of:
- Altered behaviour / personality / conscious level
- New onset seizure activity
- New onset focal neurological signs
Investigations
- Lumbar puncture
- Bacterial culture
- Viral PCR
- Cell counts / microscopy
- Protein and glucose
EEG
MRI brain
Infection Control
Isolate with contact precautions
Treatment
ACICLOVIR (IV) 10mg/kg 8 hourly
For obese patients (BMI ≥30kg/m2) dose according to adjusted body weight rather than ideal body weight (IBW)
Adjusted body weight = (0.4 x [total body weight – IBW] ) + IBW
Duration: 21 days if HSV / VZV confirmed or there is MRI / EEG evidence of encephalitis