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Medical Author:

Charles Patrick Davis, MD, PhD

Charles Patrick Davis, MD, PhD

Dr. Charles "Pat" Davis, MD, PhD, is a board certified Emergency Medicine doctor who currently practices as a consultant and staff member for hospitals. He has a PhD in Microbiology (UT at Austin), and the MD (Univ. Texas Medical Branch, Galveston). He is a Clinical Professor (retired) in the Division of Emergency Medicine, UT Health Science Center at San Antonio, and has been the Chief of Emergency Medicine at UT Medical Branch and at UTHSCSA with over 250 publications.

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Medical Editor:

Melissa Conrad Stöppler, MD, Chief Medical Editor

Melissa Conrad Stöppler, MD, Chief Medical Editor

Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.

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Encephalitis is usually a viral illness, which means that antibiotics are not used to treat viral infections. However, some antiviral drugs have been used to treat HSV infections, and some doctors may attempt to use antiviral drugs on other acute viral infections. No antiviral drugs to date are used to treat arboviral infections.

As mentioned previously, there are other nonviral causes (see above) of encephalitis, so the treatment for a given case actually depends on the doctor's working diagnosis. If the encephalitis is due to nonviral causes, then other treatments, specific to the cause, are warranted. Many clinicians consult an infectious disease, immunology, or cancer expert to help manage the various types of treatments. With the exception of herpes encephalitis, the mainstay of treatment is symptom relief. People with viral encephalitis are kept hydrated with IV fluids while monitoring for brain swelling. Anticonvulsants can be given for seizure control. Steroids have not been established as being effective although they may still be used in some cases.

• Herpes encephalitis can cause rapid death if not diagnosed and treated promptly. Therefore, medication is usually started when the doctor suspects herpes to be the diagnosis without waiting for the confirmatory results. The recommended treatment is acyclovir (Zovirax) given by IV for two to three weeks. Acyclovir-resistant herpes encephalitis can be treated with foscarnet (Foscavir). Liver and kidney functions are monitored through the course of medication.
• Currently, the use of antiviral drugs in the treatment of other types of viral encephalitis is being studied.

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