A Case Report on Viral Meningoencephalitis with Radiculoneuropathy
Meningoencephalitis is an inflammation of brain and its surrounding membranes. It can be caused by bacteria, viruses, fungi, protozoa and by various other etiology. Radiculoneuropathy, also commonly referred to as pinched nerve, refers to a set of conditions in which one or more nerves are affected. The classic triad of fever, stiff neck and altered sensorium are seen in <50% of all patients with meningitis. Clinical presentation of viral encephalitis includes a prodrome of fever, headache, myalgia, and mild respiratory infection. Altered mentation, focal neurological deficits and seizures usually follow. Patient was brought to emergency department of hospital. He provided with empirical anti-biotic therapy and supportive care. Laboratory investigation like CSF analysis, liver function test, renal function test. Blood test like complete blood picture, dengue Ag. Microbiological test was also carried out. Radiological imaging like MRI of Brain, MRI of spine, Chest X-Ray. Upon clinical diagnosis patient was provided with antibiotic, antiviral and supportive care. Patient was also provided with mechanical ventilator. He was treated for 14 days.
Keywords: meningoencephalitis, CSF analysis, classical triad.
2. Hasbun R, Bijlsma M, Brouwer MC, et al. Risk score for identifying adults with CSF pleocytosis and negative CSF Gram stain at low risk for an urgent treatable cause. J Infect 2013; 67:102–10.
3. George BP, Schneider EB, Venkatesan A. Encephalitis hospitalization rates and inpatient mortality in the United States, 2000-2010. PLoS One 2014; 9:e104169
4. Kroll H, Duszak R Jr, Nsiah E, Hughes DR, Sumer S, Wintermark M. Trends in lumbar puncture over 2 decades: a dramatic shift to radiology. AJR Am J Roentgenol 2015; 204:15–9.
5. Sapra H, Singhal V. Managing Meningoencephalitis in Indian ICU. Indian J Crit Care Med. 2019; 23(Suppl 2):S124-S128.
6. van de Beek D,, de Gans J,, Spanjaard L,, Weisfelt M,, Reitsma JB,, Vermeulen M. Clinical features and prognostic factors in adults with bacterial meningitis. N Engl J Med. 2004; 351((18):):1849––1859.
7. Ford-Jones, E L et al. “Acute childhood encephalitis and meningoencephalitis: Diagnosis and management.” Paediatrics & child health vol 3
8. Barry E, Hauser WA. Pleocytosis after status epilepticus. Arch Neurol. 1994; 51:190–3
9. Jeffrey JKM, Read SJ, Peto TEA, et al. Diagnosis of viral infections of the central nervous system: clinical interpretation of PCR results. Lancet. 1997; 349:313–7
10. Lakeman FD, Whitley RJ, the NIACA Study Group Diagnosis of herpes simplex encephalitits: application of polymerase chain reaction to cerebrospinal fluid from brain-biopsied patients and correlation with disease. J Infect Dis. 1995; 171:857–63
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
Authors who publish with this journal agree to the following terms:
- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution-NonCommercial 3.0 Unported License. that allows others to share the work with an acknowledgment of the work's authorship and initial publication in this journal.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgment of its initial publication in this journal.
- Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access).