Herpesencephalitis
An inflammation in the brain caused by bacteria, usually meningitis, must be treated as soon as possible. After the liquor has been taken for diagnostic purposes, antibiotic therapy is started immediately. Antibiotic-resistant strains can be found more and more often, especially in hospitals.
The right combination of different effective drugs prevents the further development of resistance and increases the success of the therapy. A common side effect of antibiotic therapy is an allergic reaction to the medication. It is therefore important to pay attention to known allergies and to adjust the medication accordingly.
Once the pathogen has been detected, a specific antibiogram can be started. Factors that require special attention are the cerebrospinal fluid flow – Will the medication reach its site of action? – and the toxicity of the drug.
The benefits must be weighed against the possible harm that the patient might suffer as a result of the treatment. A specific therapy must be applied in case of infection with Mycobacterium tuberculosis. This is the causative agent of tuberculosis and tuberculous meningitis that occurs in the secondary stage.
The use of up to five combined antituberculotics promises a successful therapy. Mass killing of bacteria can lead to the Jarisch-Herxheimer reaction. The body is flooded with bacterial remains and nausea, high fever, headaches and other symptoms can occur, sometimes ending in a state of shock.
The encephalitides, which are mainly caused by viruses, are treated with painkillers (analgesics) and bed rest in mild cases. If the symptoms are more severe, antivirals such as Aciclovir are used. In HIV disease, special antiretroviral drugs are used which, although they do not cure the patient, inhibit or even stop the manifestation.
What are the chances of recovery from an inflammation of the brain?
The chances of recovery from encephalitis depend largely on the time of diagnosis and the subsequent therapy. In general, the prognosis without therapy is extremely poor with a mortality rate of 70-80%. However, if early signs such as neurological deficits, severe headaches and fever are detected and immediate therapy is initiated, the mortality rate can be greatly reduced.
In case of an infection with the herpes virus, the mortality rate is 10-20% nowadays. The therapeutic approach here is that as long as the pathogen is not known, one tries to fight all possible pathogens, for example by administering antibiotics against bacteria and simultaneously initiating an antiviral therapy with Aciclovir. Once the exact pathogen is identified, the therapy can be further specified. This therapy scheme has drastically improved the chances of cure in recent years. The extent of consequential damage can usually only be conclusively assessed after some time.
