Dexamethasone in Enteric Fever Encephalitis

Mechanistic Rationale

Dexamethasone attenuates the subarachnoid space inflammatory response that contributes to morbidity and mortality in enteric fever encephalopathy, similar to its mechanism in bacterial meningitis, by decreasing cerebral edema, increased intracranial pressure, altered cerebral blood flow, cerebral vasculitis, and neuronal injury mediated by pro-inflammatory cytokines 1, 2
The steroid's effects on cerebral edema, increased intracranial pressure, altered cerebral blood flow, cerebral vasculitis, and neuronal injury mediated by pro-inflammatory cytokines are critical in reducing morbidity and mortality in enteric fever encephalopathy 1, 2

The American Academy of Pediatrics and other guideline societies recommend dexamethasone dosing for bacterial meningitis, which may be applicable to enteric fever encephalopathy, as follows: