Infectious Encephalitis in the Neurocritical Care Unit

Purpose of review: Infectious encephalitis is a rapidly progressive encephalopathy caused by a variety of pathogens, most commonly viruses. It is associated with significant mortality and morbidity, often requiring evaluation and treatment in the intensive care unit. This review article discusses the diagnosis of the infectious etiologies, the assessment for differential diagnoses, and the initiation of therapies, and most importantly, it entails the rapid and efficient management of the associated complications. Recent findings: Novel emerging technologies (e.g., metagenomic next-generation sequencing) have the potential to assist in the diagnosis, etiology identification, and treatment of encephalitis. Interventions such as ketogenic diet therapies have been promising in their potential to treat patients with refractory status epilepticus in the setting of infectious encephalitides. Summary: Early recognition of encephalitis and appropriate treatment of the primary infection and its complications are essential to increase survival and reduce sequelae. Intensivists are crucial given the high mortality rate of infectious encephalitis in the ICU setting, and their role may significantly impact patients’ outcomes.