Complications
Neurological complications resulting from encephalitis (e.g., seizure, disorientation, and ataxia) are seen in up to 14% of patients with VEEV infection, with highest prevalence in children.[30] Neurological complications appear to be more prevalent among the epizootic VEEV subtypes (IAB and IC) compared with the enzootic subtypes.[4] VEEV can cause neurological complications as it can infect the central nervous system of the host. Monitoring for elevated intracranial pressure may prevent brain herniation and death.
Seizures are a complication of VEEV infection seen most commonly in children. In a large outbreak in Venezuela in 1995, 70.6% of 313 patients hospitalised with encephalitis resulting from VEEV infection presented with seizures.[27] Anticonvulsants should be used to manage such seizures, but treatment must be monitored to ensure that therapeutic levels are achieved.
Pregnant women with VEEV infection may be at risk of stillbirth and spontaneous abortion.[32]
There are case reports of severe gastrointestinal (GI) bleeding associated with VEEV infection.[3] Histopathological studies reveal marked lymphocyte depletion and follicular necrosis of the GI tract in patients infected with VEEV, which may explain this association.[35] Fluid resuscitation and administration of blood products are successful treatments in certain instances.[3]
Mild to severe hepatitis may occur in people with VEEV infection. Histopathological examination of patients infected with VEEV has revealed hepatocellular degeneration.[35]
Histopathological examination of patients infected with VEEV has revealed interstitial pneumonia, which may be complicated by acute bronchopneumonia.[35]
Sensory defects (e.g., reduction in hearing, taste, and smell) may occur in the long-term as a result of neurological complications caused by VEEV infection.[44]
Use of benzodiazepines for seizure control in an emergency may result in hypotension and sedation with a need for intubation to protect the patient's airway.
Anticonvulsants (such as phenytoin) have many drug-drug interactions, are generally not recommended in pregnancy, and have many possible adverse effects (e.g., confusion, trouble with speech, swallowing, tremors).
Use of this content is subject to our disclaimer