Treatment of Nipah Virus Infection Presenting as Encephalitis

Nipah virus can cause severe illness characterised by inflammation of the brain (encephalitis). This presentation requires urgent structured management targeting the consequences of neuroinflammation and raised intracranial pressure.

Clinical Scenario

In patients infected with Nipah virus, encephalitis is one of the recognised syndromic presentations — alongside ARDS and myocarditis. The encephalitic form involves brain inflammation with the potential for raised intracranial pressure and seizure activity, demanding a coordinated critical-care approach.

Approach to Management

      Management centres on controlling intracranial pressure and systemic complications of encephalitis — including agents to reduce cerebral oedema — together with an anticonvulsant strategy for seizure control. The full stepwise regimen, including drug selection and sequencing, is in the complete protocol.
    

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References

The syndromic presentations are ARDS, Myocarditis and Encephalitis.

In infected people, Nipah virus causes severe illness characterized by inflammation of the brain (encephalitis) or respiratory diseases.

Manage Fever, pain with paracetamol, avoid NSAIDs. Elevate head above the heart (usually 30 degrees). Furosemide 0.5 to 1.0 mg/kg IV and/or mannitol 1 g/kg IV over 30–60 minutes, repeat dosing can be given as needed, generally every eight hours — provided circulatory volume is protected. Control of systemic hypertension. IV Sedation and mechanical ventilation. Lorazepam 4 mg IV or Phenytoin 100 mg IV q6-8h or Fosphenytoin 150 PE q8h IV or Levetiracetam 500 mg q8-12h IV.

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