Elderly Man Recovers from Infectious Encephalitis After 14 Days of Targeted Treatment
When 80-year-old Mr. Wang began experiencing persistent low-grade fever and severe headaches, his family initially suspected a common upper respiratory infection. However, as his condition worsened and symptoms progressed to confusion and extreme fatigue, they quickly realized the severity of his illness. After being rushed to Shandong Third Provincial Hospital in May 2022, he was diagnosed with infectious encephalitis and began a comprehensive treatment plan that ultimately led to significant improvement in his condition.
Medical Overview
Patient: Male, 80 years old
Diagnosis: Infectious encephalitis
Hospital: Shandong Third Provincial Hospital
Treatment Period: May 2022
Treatment Approach: Intravenous medications including mannitol, dexamethasone, ceftriaxone, and ribavirin
Recovery Timeline: 14 days of inpatient care followed by a 1-month outpatient follow-up
Outcome: Stabilized condition with noticeable symptom relief and cognitive improvement
Initial Presentation and Diagnosis
Mr. Wang first developed flu-like symptoms, followed by a week-long low fever ranging between 37°C and 38°C. He also experienced intense headaches that progressively worsened. By the third day of illness, he became increasingly drowsy, with persistent fever, nausea, and vomiting. Concerned about the sudden deterioration, his family brought him to the hospital for further evaluation.
Upon examination, Mr. Wang was found to be in a state of lethargy—responsive to verbal stimuli but unable to fully cooperate with neurological testing. Based on these findings, doctors suspected central nervous system involvement and recommended hospitalization. Further diagnostic tests, including MRI and lumbar puncture, were advised to confirm the underlying cause.
Diagnostic Process and Treatment Plan
Once admitted, Mr. Wang underwent a full panel of laboratory tests, including blood work, inflammatory markers, and immune screening. MRI imaging revealed abnormal signals within the cerebral hemisphere, raising suspicion for encephalitis. Cerebrospinal fluid analysis confirmed the diagnosis, showing elevated white blood cell count (856 × 10^6/L), high protein levels (9.5 g/L), and increased intracranial pressure (210 mmHg).
Given the severity of his condition and the risk of life-threatening complications such as respiratory failure or secondary pneumonia, a multidisciplinary treatment strategy was implemented. He received intravenous mannitol to reduce brain swelling, dexamethasone to manage inflammation, and a combination of antibiotics and antiviral medications—ceftriaxone and ribavirin—to target the underlying infection.
Ongoing Monitoring and Family Communication
Due to Mr. Wang's advanced age and the critical nature of his illness, the medical team maintained open and transparent communication with his family. They were informed of potential complications, including cardiac stress and pulmonary infections, and expressed full understanding and cooperation throughout the treatment process.
Progress and Recovery
After one week of intensive therapy, Mr. Wang's fever subsided and his neurological symptoms began to improve. His consciousness level improved significantly, although he remained slightly sluggish. By the end of the 14-day treatment period, his cognitive function had returned to near baseline, and his motor strength and coordination were intact.
One month after discharge, a follow-up phone call confirmed that Mr. Wang had continued to recover without setbacks. He reported no new symptoms and was gradually regaining his strength and independence at home.
Post-Discharge Care Recommendations
For elderly patients like Mr. Wang, ongoing monitoring is essential. Family members were advised to track his temperature daily and observe for any changes in mental status or cognitive function. Regular physical assessments were also recommended to detect early signs of neurological decline.
In addition to medical follow-up, lifestyle modifications were emphasized. These included staying well-hydrated, consuming nutrient-rich and easily digestible meals, avoiding spicy or hard-to-digest foods, engaging in light physical activity such as walking, and performing regular limb massages to prevent deep vein thrombosis.
Clinical Insights and Preventive Awareness
Infectious encephalitis is a potentially life-threatening neurological condition that requires prompt diagnosis and aggressive treatment. Delayed intervention can lead to long-term disability or even death. In this case, the patient's family played a crucial role in recognizing the red flags—persistent headache, fever, vomiting, and altered mental status—and seeking timely medical attention.
Healthcare providers should maintain a high index of suspicion for central nervous system infections in elderly patients presenting with non-specific neurological symptoms. Early lumbar puncture and appropriate imaging are essential for accurate diagnosis and targeted therapy.
From a preventive perspective, maintaining strong immunity through balanced nutrition, regular exercise, and routine health screenings can significantly reduce the risk of severe infections. Family caregivers are encouraged to stay vigilant and seek professional help immediately if an elderly loved one shows signs of confusion, persistent fever, or neurological changes.