Viral Infections of the Central Nervous System

Smuts, Izelle; Lamb, Gregory V.

doi:10.1007/978-3-319-54093-1_4

Cited by 2 publications

(2 citation statements)

References 76 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Due to the patient recurrent high fever, piperacillin-sodium-tazobactam (imported) 4.5g q8h was empirically added for anti-infection treatment, along with acyclovir injection 0.5g q8h for antiviral treatment, and dexamethasone sodium phosphate injection 2 mL qd for anti-inflammatory treatment. [3,4] Later, the patient CSF results showed CSF biochemistry: chloride: 111 mmol/L↓, glucose: 3.47 mmol/L, trace protein:1493 mg/L↑, and trace albumin: 634 mg/L↑. CSF routine: colorless, clear, red blood cells: 4-6/HP, white blood cells: 7-10/HP, Pandy test negative, white blood cell count: 159 × 10 6 /L, mononuclear white blood cells: 98%, polymorphonuclear white blood cells: 2%.…”

Section: Case Reportmentioning

confidence: 99%

“…The patient received regular antiviral treatment for 5 weeks and dexamethasone sodium phosphate injection 10 mg, qd for 10 days. [ 3 , 4 ] During the treatment, the patient blood pressure continued to decrease, so an infusion of 32 mL saline solution and 180 mg dopamine hydrochloride injection was administered to maintain blood pressure. Fluid therapy was also given.…”

Section: Case Reportmentioning

confidence: 99%

See 1 more Smart Citation

A case of successful hormone therapy for refractory hypotension following viral encephalitis: Case report

Zhang,

Liao

2023

Medicine

View full text Add to dashboard Cite

Rationale: Refractory hypotension is a life-threatening condition that can result from various causes. We report a rare case of refractory hypotension following herpes simplex virus type 1 encephalitis that was successfully treated with hormone therapy. Patient concerns: The patient was a 66-year-old male who was admitted to the hospital because of fever, chills, convulsions, and impaired consciousness. He developed respiratory failure and was intubated. Cerebrospinal fluid metagenomic sequencing confirmed herpes simplex virus type 1 infection. He received piperacillin-tazobactam for anti-infection, acyclovir for antiviral therapy, and dexamethasone for anti-inflammatory therapy. He had repeated episodes of hypotension despite fluid resuscitation and vasopressor therapy. Diagnosis: The diagnosis of herpes simplex virus type 1 encephalitis complicated by refractory hypotension was based on the patient’s epidemiological history, clinical manifestations, laboratory tests, and imaging studies. Cerebrospinal fluid examination was the most important diagnostic method, which could detect viral nucleic acids. Head magnetic resonance imaging showed a large recent lesion in the right temporal-parietal and insular lobes. Interventions: The treatment of refractory hypotension mainly included anti-infection, antiviral, anti-inflammatory, and hormone therapy. Hormone therapy used methylprednisolone shock treatment until tapering withdrawal. Other treatments included fluid resuscitation, vasopressors, anticonvulsants, etc. Outcomes: The patient’s blood pressure stabilized after receiving methylprednisolone shock treatment, and his mean arterial pressure increased from 73 mm Hg to 92 mm Hg within 24 hours. Three months later, the patient’s blood pressure was normal without medication, and he had a good social and physical recovery. Lessons: This case illustrates the possible role of hormone therapy in restoring blood pressure in patients with refractory hypotension following viral encephalitis. It suggests that adrenal insufficiency or autonomic dysfunction may be involved in the pathophysiology of this condition. Further studies are needed to confirm the efficacy and safety of hormone therapy in this setting.

show abstract

Section: Case Reportmentioning

confidence: 99%

Section: Case Reportmentioning

confidence: 99%