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Akut encefalit

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Definition:
Akut inflammation i hjärnan med tillhörande neurologiska symtom. Beror antingen på en primär virusinfektion eller är en immunmedierad, ofta postinfektiös inflammation.
Förekomst:
Incidensen av viral encefalit skattas till 3,5–7,4 per 100 000 personer per år – de allra flesta är lindriga fall.
Symtom:
Både akuta symtom och gradvis utveckling av symtom över dagar är vanliga. Encefalopati av ett eller annat slag är det vanligaste symtomet.
Kliniska fynd:
Generella infektionstecken, neurologiska manifestationer och eventuellt meningeal retning.
Diagnostik:
Mikrobiologisk diagnos kan vara svår att ställa, men neurologiska manifestationer och patologisk spinalvätska bekräftar diagnosen.
Behandling:
Tidig behandling med aciklovir vid misstanke om virusencefalit, särskilt herpesencefalit.
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  • Birgitta Evengård, senior professor i infektionssjukdomar vid Umeå universitet, Institutionen för Klinisk Mikrobiologi