80-Year-Old Man Recovers from Infectious Encephalitis After 14 Days of Treatment

In this medical case study, we follow the journey of an 80-year-old male patient who was diagnosed with infectious encephalitis and successfully treated with a combination of medications. The patient initially experienced mild symptoms that rapidly progressed, highlighting the importance of timely medical intervention.

Case Overview

The patient, an 80-year-old man, first noticed persistent low-grade fever and severe headaches approximately one week prior to hospitalization. Initially mistaken for a common cold or upper respiratory infection, the condition worsened, leading to confusion and drowsiness. Prompt medical evaluation led to a diagnosis of infectious encephalitis. After a 14-day treatment regimen and follow-up care, the patient showed significant improvement and was discharged with stable health.

Patient Profile

Age: 80 years
Gender: Male
Diagnosis: Infectious Encephalitis
Hospital: Shandong Third Provincial Hospital
Admission Date: May 2022
Treatment: Intravenous medications including Mannitol, Dexamethasone, Ceftriaxone, and Ribavirin
Recovery Time: 14 days inpatient care, followed by outpatient follow-up after one month
Outcome: Significant symptom relief and stable neurological condition

Initial Presentation and Diagnosis

The patient first developed flu-like symptoms including a low-grade fever (37°C–38°C) and intense headaches. After three days, he became increasingly drowsy and began experiencing nausea and vomiting. Concerned family members brought him to the hospital for further evaluation. Neurological examination revealed altered consciousness and impaired responsiveness. Based on these findings, doctors suspected central nervous system involvement and recommended hospitalization for further diagnostic testing.

Treatment Plan and Progress

Upon admission, a comprehensive set of tests was conducted, including blood work, inflammatory markers, and imaging studies. MRI results showed abnormal brain signals consistent with encephalitis. Lumbar puncture confirmed the diagnosis, revealing elevated white blood cell count (856×10^6/L), high protein levels (9.5g/L), and increased intracranial pressure (210mmHg).

The treatment plan included:

Mannitol Injection: To reduce brain swelling and intracranial pressure
Dexamethasone: For anti-inflammatory support
Ceftriaxone: Broad-spectrum antibiotic coverage
Ribavirin: Antiviral therapy

Given the severity of the condition, the medical team thoroughly explained the risks—including possible secondary infections and cardiac complications—to the family. Fortunately, the patient responded well to the treatment.

Recovery and Follow-Up

After one week of intensive care, the patient's fever subsided, and his headache, nausea, and confusion improved significantly. By the 14th day, his cognitive function had largely returned, with only mild impairment noted. Motor function remained intact, and he was discharged with a stable condition. A follow-up phone call one month later confirmed continued recovery with no relapse or complications.

Post-Discharge Care Recommendations

For elderly patients recovering from severe neurological illness, ongoing monitoring is essential. Key recommendations included:

Daily temperature checks
Observation of mental status and cognitive changes
Regular assessment of motor function
Hydration and a nutrient-rich, easily digestible diet
Avoidance of spicy, cold, or hard-to-digest foods
Moderate physical activity such as walking
Regular limb massage to prevent deep vein thrombosis

Clinical Insights and Takeaways

Infectious encephalitis is a life-threatening neurological condition that requires immediate diagnosis and treatment. Delayed intervention can lead to long-term disability or fatal outcomes. This case illustrates the critical role of early recognition and family vigilance in improving patient outcomes.

Healthcare providers should prioritize rapid diagnostic testing to identify the causative agent and initiate appropriate therapy. Additionally, maintaining a strong immune system through proper nutrition, rest, and regular exercise can help reduce the risk of such severe infections, especially in older adults.