• Paper Title: State of the Art: Acute Encephalitis • Journal Name: Clinical Infectious Diseases • DOI: doi.org/10.1093/cid/ciad306 • Background: Encephalitis remains a devastating neurologic disease frequently resulting in prolonged neurologic deficits. While incidence has remained stable, the field has been transformed by the emergence of new infectious agents and the recognition of numerous autoimmune conditions. • Methods: This state-of-the-art review updates clinical management strategies for adults and children (older than 6 months), focusing on evidence-based practices and expert opinions where data are lacking. • Results: Best practices now mandate universal testing for a core group of etiologies, including HSV-1, VZV, enteroviruses, West Nile virus, and anti-NMDAR antibody encephalitis. Empiric acyclovir should be initiated immediately at presentation. For the 50% of cases where a cause is not initially identified, advanced strategies such as next-generation sequencing (NGS), repeat imaging, or brain biopsy are recommended. • Conclusions: The rapid discovery of autoimmune markers and the implementation of molecular diagnostics like NGS have significantly improved diagnostic yields and patient outcomes, though the development of novel therapeutics remains a high research priority.
