Viral Encephalitis: Etiology, Clinical Features, Diagnosis and Management

Sergio Ferrari1, Antonio Toniolo2, Salvatore Monaco1, Filippo Luciani3, Francesca Cainelli4, Andreina Baj2, Zelalem Temesgen5, Sandro Vento*, 1
1 Department of Neurological and Visual Sciences, Section of Neurology, University of Verona, Verona, Italy
2 Laboratory of Medical Microbiology, University of Insubria, Varese, Italy
3 Infectious Diseases Unit, Annunziata Hospital, Cosenza, Italy
4 Department of Emergency Medicine, Annunziata Hospital, Cosenza, Italy
5 Division of Infectious Diseases, Mayo Clinic College of Medicine, Rochester, MN, USA

© 2009 Ferrari et al.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

* Address correspondence to this author at the Infectious Diseases Unit, Annunziata Hospital, 87100 Cosenza, Italy; Tel/Fax: 39.0984.681360; E-mail:


Viral encephalitis is worldwide spread pathology with high morbidity and mortality. Its incidence is higher in children. Enteroviruses, varicella zoster virus and herpes simplex viruses are the most frequent agents. However, in spite of the use of modern microbiological and radiological methods, an etiological diagnosis is reached in less than 50% of cases, making a careful differential diagnosis with non viral brain diseases imperative. Pathogenesis is elusive and therapy continues to remain supportive in almost all cases, as the only virus-directed treatment is available for herpesvirus-related encephalitis and a role for steroids continues to be debated. Novel and more targeted therapies are eagerly needed.