Paediatric Virology and its interaction between basic science and clinical practice (Review)

Mammas, Ioannis N.; Greenough, Anne; Theodoridou, Maria; Kramvis, Anna; Rusan, Maria; Melidou, Angeliki; Korovessi, Paraskevi; Papaioannou, Georgia; Papatheodoropoulou, Alexia; Koutsaftiki, Chryssie; Liston, Maria; Sourvinos, George; Spandidos, Demetrios A.

All patients with suspected viral encephalitis start treatment with acyclovir and if the PCR test is positive for HSVs or VZV, should continue treatment for at least 14-21 days (93) . corticosteroids can also be used, although their role remains controversial as they have strong immunomodulatory effects, which may facilitate viral replication. Enterovirus infection requires only supportive care and in more severe cases intravenous immunoglobulin (IVIG) alone or in combination with high doses of corticosteroids (90) . Other drugs, such as oseltamivir or ganciclovir, are administered according to the underlying viral cause. Viral CNS infections are a life-threatening emergency. Supportive care is crucial and includes airway management, cardiorespiratory support, the maintenance of fluids and electrolyte balance and the management of seizures, according to specific guidelines (94) . Approximately 30% of patients require PICU admission. The overall mortality rates range from 0 to 7%, depending on the pathogen, age and clinical and laboratory findings at the time of presentation. Approximately 35% of survivors will suffer from some form of permanent disability (seizures, learning problems, motor deficits, developmental delay) with much a higher incidence, two thirds of patients, in HSV encephalitis cases.