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West Nile Fever: Treatment and Prevention
Last reviewed: 23.04.2024
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Treatment of West Nile fever is a syndrome, since the effectiveness of antiviral drugs has not been proven. To combat cerebral hypertension, furosemide is administered to adults 20-60 mg per day, maintaining a normal volume of circulating blood. When the symptoms of swelling-swelling of the brain increase, mannitol is prescribed in a dose of 0.5 g / kg of body weight in a 10% solution, administered rapidly for 10 minutes, followed by 20-40 mg of furosemide intravenously. In severe cases (coma, respiratory disorders, generalized convulsions), additionally, dexamethasone (dexazone) is administered at a dose of 0.25-0.5 mg / kg per day for 2-4 days. Detoxification and compensation of fluid loss are carried out by intravenous infusions of polyionic solutions (trisol solution). Polarizing mixture and colloidal solutions (10% albumin solution, cryoplasma, rheopolyglucin, reoglumane) in a ratio of 2: 1. The optimal daily volume of injected fluid, including oral and probe injection, is 3-4 liters for adults and 100 ml / kg of body weight for children.
To combat hypoxia, inhalation of oxygen through nasal catheters is used. Patients are transferred to mechanical ventilation by the following indications: excessive dyspnea (BH twice or more above the norm), persistent hypoxemia (PaO, less than 70 mm Hg), hypocapnia (Raco, less than 25 mm Hg), or hypercapnia Raco 2 more than 45 mm Hg), coma, generalized convulsions. Correction of electrolyte disturbances and blood osmolarity is performed.
According to individual indications, treatment of fever of the western Nile requires nasazaniya anticonvulsant, sedative drugs, antioxidants, drugs that improve cerebral blood flow (pentoxifylline), in the presence of secondary bacterial complications - antibiotics.
Patients need balanced enteral-parenteral nutrition, which includes a complex of vitamins and microelements, complete care (prevention of hypostatic pneumonia, pressure ulcers, control of stool and diuresis).
The discharge of patients is carried out after a stable temperature normalization, regression of neurological disorders and sanation of the cerebrospinal fluid. The minimum duration of inpatient treatment for patients with neurotoxicosis is 10 days, meningitis is 20 days, meningoencephalitis is 30 days. After discharge from the hospital, patients with neurologic disorders need to be monitored by a neurologist before the full recovery of work capacity and regression of neurological symptoms.
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