From the Guidelines
The Johns Hopkins Encephalitis Center in Maryland has a hotline assistance line (HAL) that intensivists from Florida or elsewhere can use for consultation on complex cases like HSV-1 encephalitis. When managing a complex case of Herpes Simplex Virus-1 (HSV-1) Encephalitis, it is crucial to consider the most recent and highest quality evidence to guide treatment decisions, such as the study by the Infectious Diseases Society of America 1. The main contact number for the Johns Hopkins Encephalitis Center is 410-614-4984, and for urgent consultations, physicians should call the Hopkins Access Line at 410-955-9444 and ask to speak with the neurologist on call for the Encephalitis Center. Some key points to consider when collaborating with the Encephalitis Center include:
- The importance of early treatment with acyclovir, as mortality decreases to 8% if therapy is initiated within 4 days after onset of clinical symptoms 1
- The use of acyclovir at a dosage of 10 mg/kg intravenously every 8 h for 14–21 days in patients with normal renal function 1
- The potential benefits of adjunctive corticosteroids, although more research is needed to confirm this 1
- The need for close monitoring and potential continuation of antiviral therapy if a negative CSF PCR result is not achieved at the end of therapy 1 When calling the Encephalitis Center, be prepared to provide patient clinical information, current treatment regimens, imaging results, and CSF findings to ensure the best possible collaboration and guidance on managing the complex case. The Encephalitis Center offers multidisciplinary expertise in managing complex viral encephalitis cases and can provide guidance on diagnostic approaches, treatment modifications, and management of complications, which can be particularly valuable for challenging cases that may require specialized knowledge or alternative therapeutic approaches beyond standard protocols.
From the Research
Hospital Acquisition Line (HAL) for Collaboration
- There is no direct evidence to suggest that the Johns Hopkins Encephalitis Center in Maryland has a Hospital Acquisition Line (HAL) for an intensivist from a Florida Medical Center to collaborate on a complex case of Herpes Simplex Virus-1 (HSV-1) Encephalitis [ 2, 3, 4, 5, 6 ].
Collaboration and Treatment of HSV-1 Encephalitis
- The treatment of HSV-1 encephalitis typically involves the use of antiviral medications such as acyclovir [ 2, 3, 4, 5, 6 ].
- Some studies suggest that adjunctive immunomodulatory therapy, such as intravenous immunoglobulin (IVIG) and glucocorticoids, may be beneficial in severe cases of HSV-1 encephalitis [ 3, 5 ].
- Collaboration between intensivists and other healthcare professionals is crucial in the management of complex cases of HSV-1 encephalitis, but there is no specific information available on the existence of a Hospital Acquisition Line (HAL) for this purpose [ 2, 3, 4, 5, 6 ].