Nipah virus infection can manifest as severe brain inflammation (encephalitis), a critical presentation that demands prompt, structured in-hospital management. This page describes the clinical scenario and the general management priorities; the complete evidence-based protocol is available via the link below.

Clinical Scenario

This protocol applies to patients with confirmed or suspected Nipah virus infection presenting with encephalitis — inflammation of the brain resulting from viral involvement of the central nervous system. Nipah virus causes severe illness characterised by encephalitis or respiratory disease; the encephalitic syndrome is among the recognised life-threatening presentations alongside ARDS and myocarditis.

Management Approach — Partial Overview

Care is directed at managing raised intracranial pressure and controlling seizures. The approach involves specific measures for fever management, patient positioning, reduction of intracranial pressure using osmotic and diuretic agents, blood pressure control, ventilatory support, and anticonvulsant therapy. The specific agents, dosing, sequence, and decision algorithm are contained in the full structured protocol.

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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Treatment of Nipah Virus Infection Presenting with Encephalitis

Clinical Scenario

Management Approach — Partial Overview

References