Steroid Use in Viral Encephalitides

Contrast with Other Viral Encephalitides

• The Infectious Diseases Society of America recommends against routine steroid use in HSV-1 encephalitis, though they may be considered under specialist supervision for marked cerebral edema or raised intracranial pressure 1, 2
• The concern is that immunosuppression could facilitate viral replication, as noted by the Infectious Diseases Society 3
• Corticosteroids can be considered as adjunctive therapy for VZV encephalitis, particularly with vasculopathy, with a B-II recommendation from the Infectious Diseases Society 1, 2
• This represents a different pathophysiological mechanism than dengue, as highlighted by the Journal of Infection 2