Abstract
Viral encephalitis represents a medical emergency that requires prompt diagnosis and proper management. Patient presentation includes fever, headache, mental status changes, and seizures in different combinations. While herpes simplex virus is the most common cause of sporadic encephalitis worldwide, certain arboviral (arthropod borne) infections remain a health challenge in certain parts of the globe. Zika virus has been recently added to the list of potential offenders. Despite important advances in technology, a substantial percentage of encephalitis cases still remain without a specific diagnosis. Cerebrospinal fluid analysis with viral nucleic acid detection by PCR and neuroimaging are paramount in diagnosing encephalitis and establishing a specific viral etiology. Empiric therapy with acyclovir is required in suspected cases of encephalitis, and maintained for 3 weeks upon confirmation of herpetic etiology. Without specific therapy, herpes encephalitis conveys high mortality and morbidity rates. General support measures are also critical and have been defined in pertinent guidelines. We will here review the most common encephalitis in adults and their diagnostic and therapeutic modalities.