DIAGNOSIS CHECKLIST
for Encephalitis

Why: encephalitis can present in many ways, depending partly on the organism responsible. Possible symptoms include fever, headache, stiff neck irritability, drowsiness, vomiting, seizures and sometimes psychiatric symptoms such as hallucinations.

Why: more difficult to diagnose in children e.g. symptoms in infants include fever, pallor, vomiting, lethargy, refusing to feed, bulging fontanelle, neck stiffness.

Why: e.g. post-infectious encephalitis may occur up to 14 days after infection with measles, varicella zoster (chicken pox), rubella, mumps and influenza. Other more rare causes include Rabies, polio and HIV.

Why: Measles may also cause a sub-acute sclerosing panencephalitis (SSPE) about 6 years after the original infection with slow deterioration leading to death.

Why: Bacterial cause (especially Staphlococcus aureus) is usually secondary to a pus infection elsewhere e.g. abscess.

Why: may suggest St Louis encephalitis virus, Eastern equine encephalitis (EEE), Western equine encephalitis (WEE), Japenese B encephalitis, Lyme disease.

Why: rarely an Acute disseminated encephalomyelitis may follow after immunization against rabies, influenza or pertussis.

Why: may help determine risk of neurosyphilis as a non- pus forming bacterial encephalitis; The immunocompromised patient with AIDS is susceptible to a variety of infectious agents that can attack the central nervous system e.g. most commonly herpes simplex virus and cytomegalovirus.

Why: e.g. if traveled to Far East the Japanese B arbovirus is a more usual and epidemic cause of severe encephalitis, with a high mortality.

Why: e.g. usually same symptoms as acute viral encephalitis but may have more focal neurological symptoms such as limb weakness or numbness due to added focal brain stem and/or spinal cord lesions.