Sandbox g24
- Empiric antimicrobial therapy
- Preferred regimen: Acyclovir 10 mg/kg IV q8h for 1421 days
- Specific epidemiologic considerations
- Agammaglobulinemia  Enteroviruses, Mycoplasma pneumoniae
- Age
- Neonates  Herpes simplex virus type 2, cytomegalovirus, rubella virus, Listeria monocytogenes, Treponema pallidum, Toxoplasma gondii
- Infants and children  Eastern equine encephalitis virus, Japanese encephalitis virus, Murray Valley encephalitis virus, influenza virus, La Crosse virus
- Elderly persons  Eastern equine encephalitis virus, St. Louis encephalitis virus, West Nile virus, sporadic CJD, L. monocytogenes
- Animal contact
- Bats  Rabies virus, Nipah virus
- Birds  West Nile virus, Eastern equine encephalitis virus, Western equine encephalitis virus, Venezuelan equine encephalitis virus, St. Louis encephalitis virus, Murray Valley encephalitis virus, Japanese encephalitis virus, Cryptococcus neoformans (bird droppings)
- Cats  Rabies virus, Coxiella burnetii, Bartonella henselae, T. gondii
- Dogs  Rabies virus
- Horses  Eastern equine encephalitis virus, Western equine encephalitis virus, Venezuelan equine encephalitis virus, Hendra virus
- Old World primates  B virus
- Raccoons  Rabies virus, Baylisascaris procyonis
- Rodents  Eastern equine encephalitis virus (South America), Venezuelan equine encephalitis virus, tickborne encephalitis virus, Powassan virus (woodchucks), La Crosse virus (chipmunks and squirrels), Bartonella quintana
- Sheep and goats  C. burnetii
- Skunks  Rabies virus
- Swine  Japanese encephalitis virus, Nipah virus
- White-tailed deer  Borrelia burgdorferi
- Immunocompromised persons  Varicella zoster virus, cytomegalovirus, human herpesvirus 6, West Nile virus, HIV, JC virus, L. monocytogenes, Mycobacterium tuberculosis, C. neoformans, Coccidioides species, Histoplasma capsulatum, T. gondii
- Ingestion
- Raw or partially cooked meat  T. gondii
- Raw meat, fish, or reptiles  Gnanthostoma species
- Unpasteurized milk  Tickborne encephalitis virus, L. monocytogenes, C. burnetii
- Insect contact
- Mosquitoes  Eastern equine encephalitis virus, Western equine encephalitis virus, Venezuelan equine encephalitis virus, St. Louis encephalitis virus, Murray Valley encephalitis virus, Japanese encephalitis virus, West Nile virus, La Crosse virus, Plasmodium falciparum
- Sandflies  Bartonella bacilliformis
- Ticks  Tickborne encephalitis virus, Powassan virus, Rickettsia rickettsii, Ehrlichia chaffeensis, Anaplasma phagocytophilum, C. burnetii (rare), B. burgdorferi
- Tsetse flies  Trypanosoma brucei gambiense, Trypanosoma brucei rhodesiense
- Occupation
- Exposure to animals  Rabies virus, C. burnetii, Bartonella species
- Exposure to horses  Hendra virus
- Exposure to Old World primates  B virus
- Laboratory workers  West Nile virus, HIV, C. burnetii, Coccidioides species
- Physicians and health care workers  Varicella zoster virus, HIV, influenza virus, measles virus, M. tuberculosis
- Veterinarians  Rabies virus, Bartonella species, C. burnetii
- Person-to-person transmission  Herpes simplex virus (neonatal), varicella zoster virus, Venezuelan equine encephalitis virus (rare), poliovirus, nonpolio enteroviruses, measles virus, Nipah virus, mumps virus, rubella virus, Epstein-Barr virus, human herpesvirus 6, B virus, West Nile virus (transfusion, transplantation, breast feeding), HIV, rabies virus (transplantation), influenza virus, M. pneumoniae, M. tuberculosis, T. pallidum
- Recent vaccination  Acute disseminated encephalomyelitis
- Recreational activities
- Camping/hunting  Agents transmitted by mosquitoes and ticks
- Sexual contact  HIV, T. pallidum
- Spelunking  Rabies virus, H. capsulatum
- Swimming  Enteroviruses, Naegleria fowleri
- Season
- Late summer/early fall  Agents transmitted by mosquitoes and ticks, enteroviruses
- Winter  Influenza virus
- Transfusion and transplantation  Cytomegalovirus, Epstein-Barr virus, West Nile virus, HIV, tickborne encephalitis virus, rabies virus, iatrogenic CJD, T. pallidum, A. phagocytophilum, R. rickettsii, C. neoformans, Coccidioides species, H. capsulatum, T. gondii
- Travel
- Africa  Rabies virus, West Nile virus, P. falciparum, T. brucei gambiense, T. brucei rhodesiense
- Australia  Murray Valley encephalitis virus, Japanese encephalitis virus, Hendra virus
- Central America  Rabies virus, Eastern equine encephalitis virus, Western equine encephalitis virus, Venezuelan equine encephalitis virus, St. Louis encephalitis virus, R. rickettsii, P. falciparum, Taenia solium
- Europe  West Nile virus, tickborne encephalitis virus, A. phagocytophilum, B. burgdorferi
- India, Nepal  Rabies virus, Japanese encephalitis virus, P. falciparum
- Middle East  West Nile virus, P. falciparum
- Russia  Tickborne encephalitis virus
- South America  Rabies virus, Eastern equine encephalitis virus, Western equine encephalitis virus, Venezuelan equine encephalitis virus, St. Louis encephalitis virus, R. rickettsii, B. bacilliformis (Andes mountains), P. falciparum, T. solium
- Southeast Asia, China, Pacific Rim  Japanese encephalitis virus, tickborne encephalitis virus, Nipah virus, P. falciparum, Gnanthostoma species, T. solium
- Unvaccinated status  Varicella zoster virus, Japanese encephalitis virus, poliovirus, measles virus, mumps virus, rubella virus
- Specific clinical considerations
- General findings
- Hepatitis  Coxiella burnetii
- Lymphadenopathy  HIV, Epstein-Barr virus, cytomegalovirus, measles virus, rubella virus, West Nile virus, Treponema pallidum, Bartonella henselae and other Bartonella species, Mycobacterium tuberculosis, Toxoplasma gondii, Trypanosoma brucei gambiense
- Parotitis  Mumps virus
- Rash  Varicella zoster virus, B virus, human herpesvirus 6, West Nile virus, rubella virus, some enteroviruses, HIV, Rickettsia rickettsii, Mycoplasma pneumoniae, Borrelia burgdorferi, T. pallidum, Ehrlichia chaffeensis, Anaplasma phagocytophilum
- Respiratory tract findings  Venezuelan equine encephalitis virus, Nipah virus, Hendra virus, influenza virus, adenovirus, M. pneumoniae, C. burnetii, M. tuberculosis, Histoplasma capsulatum
- Retinitis  Cytomegalovirus, West Nile virus, B. henselae, T. pallidum
- Urinary symptoms  St. Louis encephalitis virus
- Neurologic findings
- Cerebellar ataxia  Varicella zoster virus (children), Epstein-Barr virus, mumps virus, St. Louis encephalitis virus, Tropheryma whipplei, T. brucei gambiense
- Cranial nerve abnormalities  Herpes simplex virus, Epstein-Barr virus, Listeria monocytogenes, M. tuberculosis, T. pallidum, B. burgdorferi, T. whipplei, Cryptococcus neoformans, Coccidioides species, H. capsulatum
- Dementia  HIV, human transmissible spongiform encephalopathies (sCJD and vCJD), measles virus (SSPE), T. pallidum, T. whipplei
- Myorhythmia  T. whipplei (oculomasticatory)
- Parkinsonism  Japanese encephalitis virus, St. Louis encephalitis virus, West Nile virus, Nipah virus, T. gondii, T. brucei gambiense
- Poliomyelitis-like flaccid paralysis  Japanese encephalitis virus, West Nile virus, tickborne encephalitis virus; enteroviruses (enterovirus-71, coxsackieviruses), poliovirus
- Rhombencephalitis  Herpes simplex virus, West Nile virus, enterovirus 71, L. monocytogenes
-  Tunkel, Allan R.; Glaser, Carol A.; Bloch, Karen C.; Sejvar, James J.; Marra, Christina M.; Roos, Karen L.; Hartman, Barry J.; Kaplan, Sheldon L.; Scheld, W. Michael; Whitley, Richard J.; Infectious Diseases Society of America (2008-08-01). "The management of encephalitis: clinical practice guidelines by the Infectious Diseases Society of America". Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America. 47 (3): 303327. doi:10.1086/589747. ISSN 1537-6591. PMID 18582201..mw-parser-output cite.citation{font-style:inherit}.mw-parser-output q{quotes:"\"""\"""'""'"}.mw-parser-output code.cs1-code{color:inherit;background:inherit;border:inherit;padding:inherit}.mw-parser-output .cs1-lock-free a{background:url("")no-repeat;background-position:right .1em center}.mw-parser-output .cs1-lock-limited a,.mw-parser-output .cs1-lock-registration a{background:url("")no-repeat;background-position:right .1em center}.mw-parser-output .cs1-lock-subscription a{background:url("")no-repeat;background-position:right .1em center}.mw-parser-output .cs1-subscription,.mw-parser-output .cs1-registration{color:#555}.mw-parser-output .cs1-subscription span,.mw-parser-output .cs1-registration span{border-bottom:1px dotted;cursor:help}.mw-parser-output .cs1-hidden-error{display:none;font-size:100%}.mw-parser-output .cs1-visible-error{display:none;font-size:100%}.mw-parser-output .cs1-subscription,.mw-parser-output .cs1-registration,.mw-parser-output .cs1-format{font-size:95%}.mw-parser-output .cs1-kern-left,.mw-parser-output .cs1-kern-wl-left{padding-left:0.2em}.mw-parser-output .cs1-kern-right,.mw-parser-output .cs1-kern-wl-right{padding-right:0.2em}
-  Tunkel, Allan R.; Glaser, Carol A.; Bloch, Karen C.; Sejvar, James J.; Marra, Christina M.; Roos, Karen L.; Hartman, Barry J.; Kaplan, Sheldon L.; Scheld, W. Michael; Whitley, Richard J.; Infectious Diseases Society of America (2008-08-01). "The management of encephalitis: clinical practice guidelines by the Infectious Diseases Society of America". Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America. 47 (3): 303327. doi:10.1086/589747. ISSN 1537-6591. PMID 18582201.
-  Tunkel, Allan R.; Glaser, Carol A.; Bloch, Karen C.; Sejvar, James J.; Marra, Christina M.; Roos, Karen L.; Hartman, Barry J.; Kaplan, Sheldon L.; Scheld, W. Michael; Whitley, Richard J.; Infectious Diseases Society of America (2008-08-01). "The management of encephalitis: clinical practice guidelines by the Infectious Diseases Society of America". Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America. 47 (3): 303327. doi:10.1086/589747. ISSN 1537-6591. PMID 18582201.