West nile virus medical therapy: Difference between revisions
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==Overview== | ==Overview== | ||
There is no specific [[antiviral]] treatment for | There is no specific [[antiviral]] treatment for WNV infection. Patients with mild disease may be followed-up as outpatients; whereas patients with severe disease require hospitalization and close monitoring. Current management of infected patients is based on supportive care aimed at [[symptom]] relief and prevention of [[complications]]. | ||
==Medical Therapy== | ==Medical Therapy== | ||
===Supportive care=== | ===Supportive care=== | ||
* There is no specific [[antiviral]] therapy indicated | *There is no specific [[antiviral]] therapy indicated for patients with WNV infection. | ||
* Treatment | *Treatment is aimed at supportive measurements and prevention of complications. | ||
* In | *In mild cases, patients may be followed-up as out-patients. On the other hand, severe cases often require hospitalization to receive supportive treatment, such as [[intravenous fluids]], [[analgesics]], and nursing care. | ||
*Patients with severe meningeal symptoms often require pain control for [[headaches]] | *Patients with severe meningeal symptoms often require pain control for [[headaches]], along with antiemetic therapy and rehydration for associated [[nausea]] and [[vomiting]]. | ||
*Patients with [[encephalitis]] require close monitoring for | *Patients with [[encephalitis]] require close monitoring for possible development of elevated [[intracranial pressure]] and [[seizures]]. They should also be closely monitored for possible mechanical ventilation in cases where patients are unable to protect their airways. | ||
*Acute neuromuscular [[respiratory failure]] may rapidly develop and ventilatory support may be required. | |||
*Acute neuromuscular [[respiratory failure]] may develop | |||
=== | ===Pharmacologic Therapy=== | ||
*Although various drugs have been evaluated or empirically | *Although various drugs have been evaluated or empirically administered to patients with WNV disease, none has shown specific benefit. | ||
* | *Despite common practice, there are no guidelines that recommend the use of [[ribavirin]] or [[interferon alfa-2b]] for the treatment of WNV encephalitis or meningitis.<ref name="TunkelGlaser2008">{{cite journal|last1=Tunkel|first1=Allan R.|last2=Glaser|first2=Carol A.|last3=Bloch|first3=Karen C.|last4=Sejvar|first4=James J.|last5=Marra|first5=Christina M.|last6=Roos|first6=Karen L.|last7=Hartman|first7=Barry J.|last8=Kaplan|first8=Sheldon L.|last9=Scheld|first9=W. Michael|last10=Whitley|first10=Richard J.|title=The Management of Encephalitis: Clinical Practice Guidelines by the Infectious Diseases Society of America|journal=Clinical Infectious Diseases|volume=47|issue=3|year=2008|pages=303–327|issn=1058-4838|doi=10.1086/589747}}</ref> | ||
==References== | ==References== | ||
{{Reflist|2}} | {{Reflist|2}} | ||
Revision as of 02:21, 12 September 2014
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Alejandro Lemor, M.D. [2]
Overview
There is no specific antiviral treatment for WNV infection. Patients with mild disease may be followed-up as outpatients; whereas patients with severe disease require hospitalization and close monitoring. Current management of infected patients is based on supportive care aimed at symptom relief and prevention of complications.
Medical Therapy
Supportive care
- There is no specific antiviral therapy indicated for patients with WNV infection.
- Treatment is aimed at supportive measurements and prevention of complications.
- In mild cases, patients may be followed-up as out-patients. On the other hand, severe cases often require hospitalization to receive supportive treatment, such as intravenous fluids, analgesics, and nursing care.
- Patients with severe meningeal symptoms often require pain control for headaches, along with antiemetic therapy and rehydration for associated nausea and vomiting.
- Patients with encephalitis require close monitoring for possible development of elevated intracranial pressure and seizures. They should also be closely monitored for possible mechanical ventilation in cases where patients are unable to protect their airways.
- Acute neuromuscular respiratory failure may rapidly develop and ventilatory support may be required.
Pharmacologic Therapy
- Although various drugs have been evaluated or empirically administered to patients with WNV disease, none has shown specific benefit.
- Despite common practice, there are no guidelines that recommend the use of ribavirin or interferon alfa-2b for the treatment of WNV encephalitis or meningitis.[1]
References
- ↑ 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. (2008). "The Management of Encephalitis: Clinical Practice Guidelines by the Infectious Diseases Society of America". Clinical Infectious Diseases. 47 (3): 303–327. doi:10.1086/589747. ISSN 1058-4838.