Cerebrospinal fluid examination in patients with viral encephalitis typically shows an increased cell count, elevated protein levels, and normal or slightly decreased glucose levels. Treatment requires timely antiviral therapy, symptomatic support, and prevention of complications.
1. Cerebrospinal fluid examination shows an increased cell count, including white blood cells and lymphocytes, usually predominantly lymphocytes. The cell count may be higher in the early stages of the disease and gradually decreases as the condition improves. An increased cell count suggests an inflammatory response in the meninges and brain parenchyma, and is one of the important diagnostic criteria for viral encephalitis. Clinicians should assess disease progression based on changes in cell count in conjunction with other clinical indicators and adjust the treatment plan accordingly.
2. Elevated protein levels are another characteristic change in cerebrospinal fluid examination for viral encephalitis. The degree of protein elevation is related to the severity of the inflammatory response, but it is usually within the range of 0.5-1.0 g/L, significantly lower than in bacterial meningitis. Cerebrospinal fluid protein electrophoresis can further differentiate changes in different types of protein components, providing more detailed information for diagnosis. Patients with significantly elevated protein levels should be alert to the possibility of other complications.
3. Normal or slightly decreased glucose levels are one of the important differentiating points between viral encephalitis and bacterial meningitis. Cerebrospinal fluid glucose levels are usually maintained at or slightly below the lower limit of the normal reference range, generally not lower than 60% of the blood glucose level. A slight decrease in glucose levels may be related to increased metabolic activity in nerve cells. Clinicians should combine changes in glucose levels with other test results to accurately differentiate between viral and bacterial infections, avoiding misdiagnosis and mistreatment.
4. Antiviral therapy is a key measure to control disease progression. Commonly used drugs include acyclovir and ganciclovir, which reduce nerve damage by inhibiting viral replication. For severe cases, combination therapy with glucocorticoids may be considered to reduce the inflammatory response. Simultaneously, close monitoring of adverse drug reactions is necessary, and the medication regimen should be adjusted promptly to ensure maximum treatment effectiveness.
5. Symptomatic and supportive treatment is an important means of improving prognosis. This includes measures such as controlling intracranial pressure, maintaining electrolyte balance, and nutritional support. For patients experiencing seizures, antiepileptic drugs should be administered promptly to control symptoms. Neurological rehabilitation training should be started as early as possible to promote the recovery of damaged nerve function and improve the patient's quality of life.
6. Preventing complications is a crucial part of the treatment process. It is essential to be vigilant for common complications such as pneumonia and deep vein thrombosis, and to take appropriate preventative measures. For comatose patients, special attention must be paid to pulmonary care to prevent aspiration pneumonia. Regularly monitor vital signs and neurological function, and promptly identify and address any abnormalities.
Characteristic changes in cerebrospinal fluid examination in patients with viral encephalitis provide important basis for diagnosis and disease assessment. Timely and effective antiviral treatment combined with active symptomatic and supportive treatment is the key to improving prognosis. Scientific and standardized comprehensive treatment plans can effectively control disease progression, prevent the occurrence of serious complications, and improve the quality of life of patients.