PulmCrit (EMCrit)
PulmCrit - October 23, 2017 - By Josh Farkas
"Summary: the Bullet:
- Acyclovir is nephrotoxic and lowers the seizure threshold. Therefore, universal application of empiric acyclovir to all encephalopathic patients while awaiting an HSV PCR would cause harm.
- Various decision tools are available in the literature to exclude HSV infection on the basis of CSF chemistries and immunologic status. Although this remains controversial, these tools have been validated and may provide a framework for determining which patients require empiric acyclovir.
- An algorithm incorporating pre-test probability and published decision tools is proposed":
