Cytomegalovirus encephalitis
ICD-10 B25.8 · ICD-11 1D82.Y

What Is the Treatment of Cytomegalovirus Encephalitis?

Clinical Scenario

Cytomegalovirus (CMV) encephalitis is a serious neurological manifestation of CMV disease. Outcomes in CMV-related neurologic disease are frequently poor, and prompt initiation of evidence-based treatment is critical.

Treatment Approach — Partial Overview

Current guidance supports first-line combination intravenous antiviral therapy using two specific agents given concurrently, with treatment duration guided by clinical response. Specific agents, dosing, scheduling, and the full clinical decision algorithm are available in the complete protocol.

Instant Access to Structured Evidence-Based Regimens

References

  1. Ganciclovira 5 mg/kg IV every 12 hours plus foscarneta (60 mg/kg IV every 8 hours or 90 mg/kg IV every 12 hours) (BIII)
  2. Given the poor outcomes in many patients with CMV-related neurologic disease, the Panel recommends initiating therapy with both IV ganciclovir and IV foscarnet, despite the substantial toxicities associated with such an approach (BIII).
  3. The optimal duration of therapy has not been established, but a minimum duration of 21 days is recommended, with extension based on clinical response (AIII).
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