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- W2334821586 abstract "This epidemic encephalitis differs from the usual lethargic type of the disease in that practically hone of the patients fall into a deep sleep, but are merely drowsy the greater part of the time during the febrile period. The cases which we have admitted have varied a great deal in severity. The following symptoms are present in varying degrees in all cases: headache (usually quite severe), elevated temperature with low pulse rate. (lasting usually only five days), photophobia, rigidity of neck, pain in back, dizziness, nausea, drowsiness, decrease in size of pupils, hesitancy of speech, muscular pains, constipation, furring and tremor of tongue, tremor of outstretched fingers, absence of abdominal reflexes, and knee and ankle jerks of low grade. Occasionallythere is a facial paralysis and paralysis of one extremity or both on the same side, coma, and retention of urine or inability to void. An aphasia for happenings during the febrile period is usually present when the patient begins to improve. Lumbar punctures show increased pressure, increased cell count and a positive Pandy. The normal spinal fluid cell count is below 10; positive Pandy is a spinal fluid test denoting increased globulin, thereby denoting inflammation of the cord-positive in such diseases as meningitis and latent syphilis. Quite frequently a patient is admitted with only a slight headache and slightly elevated temperature. These patients are admitted to another floor for the initial lumbar puncture. If this is negative, the patient is kept in this department until the puncture is repeated twentyfour hours later. If it is again negative, the patient is sent home. If it is positive, the patient is transported to the encephalitis division. In these instances the lumbar puncture is the only diagnostic measure. Since there is no serum the medical care consists chiefly of symptomatic treatment to give the patient comfort. Lumbar punctures are done when severe headaches are not relieved by aspirin or pyramidon 0.6 gram every four hours, or when elevation of temperature or rigidity of neck persists. Drawing off spinal fluid relieves pressure thereby relieving the above symptoms. Fifty per cent glucose is given intravenously to reduce the edema and pressure of the brain as well as for food value. Subcutaneous saline is given when patients are dehydrated due to inability to force fluid by mouth because of drowsiness. The nursing care in most instances consists of forcing fluids, especially fruit juices to build up a glycogen reserve to combat complicating infections by keeping up a high resistance." @default.
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- W2334821586 date "1934-01-01" @default.
- W2334821586 modified "2023-09-26" @default.
- W2334821586 title "The Care of Encephalitis Patients" @default.
- W2334821586 doi "https://doi.org/10.1097/00000446-193401000-00014" @default.
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