In addition to Japanese encephalitis, other viruses such as adenovirus, EB virus, echovirus, coxsackievirus, and herpes simplex virus, as well as during illnesses like mumps, measles, rubella, and chickenpox, or even after smallpox vaccination, can also cause encephalitis. Encephalitis symptoms may also appear during poliomyelitis. The severity of symptoms varies, and the prognosis differs accordingly.

bubble_chart Clinical Manifestations

1. Prodromal stage The child presents with fever, headache, myalgia, vomiting, diarrhea, and other symptoms.
2. Encephalitis symptoms Vary in severity, primarily manifesting as neuropsychiatric abnormalities. Neurological abnormalities often include fever, headache, vomiting, drowsiness, unconsciousness, convulsions, etc. In severe cases, symptoms related to the cerebrum, hypothalamus, basal ganglia, brainstem, cerebellum, and spinal cord may all exhibit abnormalities. Psychiatric manifestations include excitability, talkativeness, dysphoria, inappropriate crying or laughing, insomnia, abnormal behavior, hallucinations, delusions, or apathy, mutism, reduced activity, refusal to eat, poor orientation, memory decline, and urinary incontinence.
3. Accompanying symptoms Symptoms corresponding to viral infection may occur before or simultaneously with the onset of encephalitis.

bubble_chart Auxiliary Examination

1. The cerebrospinal fluid pressure is normal or slightly elevated. The appearance is clear or slightly turbid. The cell count is normal or increased, ranging from 10 to 500×10^6/L, with neutrophils predominating in the early stage and lymphocytes predominating later. Protein levels are increased, while glucose and chloride levels are normal.
2. The electroencephalogram (EEG) may show diffuse high-amplitude slow waves or focal slow waves. As the condition improves, the EEG gradually returns to normal. If it remains persistently abnormal, sequelae may be present.
3. Serological tests, including complement fixation tests, neutralization tests, and hemagglutination inhibition tests, should be performed on paired serum samples during the acute phase and the stage of convalescence. A diagnosis can be made if the antibody titer increases by fourfold or more.
4. Viral isolation from cerebrospinal fluid is helpful for confirming the diagnosis and identifying the pathogen. Additionally, viruses can also be isolated from whole blood, urine, feces, and nasopharyngeal secretions. Combined with serological tests, these methods can play a decisive role in confirming the diagnosis.

bubble_chart Diagnosis

Epidemiological history, including epidemic season, exposure history, symptoms associated with viral infections, and vaccination history.

bubble_chart Treatment Measures

﹝Treatment﹞

General and symptomatic management is the same as for "Japanese encephalitis." The efficacy of antiviral drugs is uncertain. For herpes encephalitis, idoxuridine can be tried at a dose of 50–100 mg/(kg·d), administered via intravenous drip, with a treatment course of 5 days; cytarabine can be used at a dose of 1–4 mg/(kg·d), administered via intravenous drip, with a treatment course of 3 days. Interferon may also be attempted for DNA or RNA viral infections. Section 10: Infectious Mononucleosis Infectious mononucleosis is an acute infectious disease caused by the Epstein-Barr virus (EBV). It commonly occurs among groups of children, with higher incidence in spring and autumn. Sporadic cases can occur at any age, in any season, and the respiratory tract serves as the entry route.

bubble_chart Prevention

Children in the acute phase should be isolated for respiratory protection, and oral secretions and their contaminants must be strictly disinfected. In collective institutions where the disease is prevalent, quarantine measures should be implemented on-site. Vaccine development has not yet been successful. During the convalescence stage, viremia may still persist, and blood donation is only permitted six months after the onset of the illness.