- Paracetamol, oral, at a maximum of 4 doses per 24 hours, 1 g 4- 6 hours per day .
- Tramadol, oral, 6 hours, 50 mg.
* Morphine, IV, from 1 to 2 mg / minute to a maximum 10 mg total dose.
Herpes simplex encephalitis
- Dilute 10 mg to 10 ml of 0.9 percent sodium chloride solution.
- Repeat this 4 hourly.
- Beware of respiratory depression in low consciousness patients.
Clinical characteristics are fever, behavioral changes and convulsions that can be either focused or generalized
There is usually no evidence of mucocutaneous involvement. Lumbar puncture shows the above characteristics of viral meningoencephalitis, but can also be haemorrhagic in nature in this condition. Temporary focus on EEG or neuroimaging supports diagnosis strongly.
A positive CSF HSV PCR test has been diagnosed.
* Aciclovir, IV, 8 hours per 10 mg / kg for 21 days.
- Launching therapy as soon as possible , i.e. The results are available before.
- Stop treatment if PCR is negative.
The therapy must be initiated and referred to the center where neuroimaging or EEG is available.When to refer:
- For neuroimaging: Patients who, despite appropriate therapy, do not respond or worsen in condition, i.e. decrease in consciousness and cranial nerve paralysis.
- This is particularly urgent in TB patients who develop hydrocephalus and require an urgent shunting procedure.