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Consensus guidelines for the investigation and management of encephalitis

Philip N Britton, Keith Eastwood, Bruce J Brew, Yusuf Nagree and Cheryl A Jones
Med J Aust 2015; 202 (11): 576-577. || doi: 10.5694/mja14.01042

A summary of a position paper for Australian and New Zealand practitioners

Encephalitis is caused by inflammation of the brain and is a challenging condition for clinicians to identify and manage. It manifests as a complex neurological syndrome with protean clinical manifestations that may be caused by a large number of aetiologies, many without effective treatments. It can be fatal and survivors often experience significant neurological morbidity. Studies have shown variable quality in case management in multiple settings,1-3 emphasising the need for consensus guidelines.

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  • Philip N Britton1,2
  • Keith Eastwood3
  • Bruce J Brew4
  • Yusuf Nagree5,6
  • Cheryl A Jones1,2

  • 1 University of Sydney, Sydney, NSW.
  • 2 The Children's Hospital at Westmead, Sydney, NSW.
  • 3 Hunter New England Health, Newcastle, NSW.
  • 4 St Vincent's Hospital, Sydney, NSW.
  • 5 Fremantle Hospital, Fremantle, WA.
  • 6 University of Western Australia, Fremantle, WA.


Acknowledgements: 

The authors of the full consensus guidelines also include: Beverley Paterson, David Durrheim, Russell Dale, Allen Cheng, Chris Kenedi, James Burrow, Peter Leman, David Smith, Kerry Read and Robert Booy. Philip Britton receives funding from a National Health and Medical Research Foundation postgraduate scholarship (APP1074547), the RACP Foundation, and the Sydney Medical School and Arkhadia Fund as Dean's Fellow/Norah Theresa Hayes-Ratcliffe Lecturer.

Competing interests:

No relevant disclosures.

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  • 2. Kneen R, Jakka S, Mithyantha R, et al. The management of infants and children treated with aciclovir for suspected viral encephalitis. Arch Dis Child 2010; 95: 100-106.
  • 3. Kelly C, Sohal A, Michael BD, et al. Suboptimal management of central nervous system infections in children: a multi-centre retrospective study. BMC Pediatr 2012; 12: 145.
  • 4. Venkatesan A, Tunkel AR, Bloch KC, et al. Case definitions, diagnostic algorithms, and priorities in encephalitis: consensus statement of the International Encephalitis Consortium. Clin Infect Dis 2013; 57: 1114-1128.
  • 5. Britton PN, Eastwood K, Paterson B, et al; Australasian Society of Infectious Diseases; Australasian College of Emergency Medicine; Australian and New Zealand Association of Neurologists; Public Health Association of Australia. Consensus guidelines for the investigation and management of encephalitis in adults and children in Australia and New Zealand. Intern Med J 2015; 45: 563-576.
  • 6. Beaman MH, Wesselingh SL. 4: Acute community-acquired meningitis and encephalitis. Med J Aust 2002; 176: 389-396. <MJA full text>
  • 7. Granerod J, Ambrose HE, Davies NW, et al. Causes of encephalitis and differences in their clinical presentations in England: a multicentre, population-based prospective study. Lancet Infect Dis 2010; 10: 835-844.

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