Evidence map›Paper›PMID 42851210›Full record

GuidelineEuropean journal of neurology2026

Diagnosis and Management of Infectious Encephalitis in Adults: Guidelines From the European Academy of Neurology and European Society of Clinical Microbiology and Infectious Diseases.

Julia Granerod, Johann Sellner, Jean-Paul Stahl, Sylviane Defres, Alexandra Mailles, Erich Schmutzhard, Elisabeth Aurelius, Thomas Whitfield, Luca Massacesi, Maarten J Titulaer and 20 more

Abstract readPractice Guideline
PubMed Full text at PMC Publisher
In one paragraph

Guideline in European journal of neurology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 1 synthesis or guideline pooled it.

  1. Guideline
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

30 authors.

Julia GranerodDepartment of Clinical Infection, Microbiology & Immunology, Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Liverpool, UK.ORCID https://orcid.org/0000-0002-2680-0415
Johann SellnerDepartment of Neurology, Landesklinikum Mistelbach, Mistelbach-Gänserndorf, Austria.
Jean-Paul StahlInfectious Diseases, Grenoble Alps University, Grenoble, France.
Sylviane DefresDepartment of Clinical Infection, Microbiology & Immunology, Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Liverpool, UK.
Alexandra MaillesESCMID Study Group on Infections of the Brain (ESGIB), Basel, Switzerland.
Erich SchmutzhardDepartment of Neurology, Medical University Innsbruck, Innsbruck, Austria.
Elisabeth AureliusDivision of Infectious Diseases, Department of Medicine, Karolinska Institute, Stockholm, Sweden.
Thomas WhitfieldDepartment of Clinical Infection, Microbiology & Immunology, Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Liverpool, UK.
Luca MassacesiDepartment of Neurosciences, University of Florence, Florence, Italy.
Maarten J TitulaerDepartment of Neurology, Erasmus University Medical Center, Rotterdam, the Netherlands.
Pille TabaInstitute of Clinical Medicine, University of Tartu, Tartu, Estonia.
Benedict D MichaelDepartment of Clinical Infection, Microbiology & Immunology, Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Liverpool, UK.
Tehmina BharuchaESCMID Study Group on Infections of the Brain (ESGIB), Basel, Switzerland.
Lance TurtleDepartment of Clinical Infection, Microbiology & Immunology, Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Liverpool, UK.
Brendan SargentDepartment of Clinical Infection, Microbiology & Immunology, Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Liverpool, UK.
Arina TamborskaDepartment of Clinical Infection, Microbiology & Immunology, Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Liverpool, UK.
Jonathan CattrallDepartment of Clinical Infection, Microbiology & Immunology, Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Liverpool, UK.
Yun HuangDepartment of Clinical Infection, Microbiology & Immunology, Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Liverpool, UK.
Eva Maria HodelDepartment of Clinical Infection, Microbiology & Immunology, Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Liverpool, UK.
Suzannah LantDepartment of Clinical Infection, Microbiology & Immunology, Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Liverpool, UK.
Glynn WebbDepartment of Clinical Infection, Microbiology & Immunology, Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Liverpool, UK.
Rajish S K ShilDepartment of Clinical Infection, Microbiology & Immunology, Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Liverpool, UK.
Shalley DharDepartment of Neurovirology, National Institute of Mental Health and Neurosciences, Bangalore, India.
Diederik van de BeekESCMID Study Group on Infections of the Brain (ESGIB), Basel, Switzerland.
Marie StudahlDepartment of Infectious Diseases, Institute of Biomedicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
Matthijs C BrouwerESCMID Study Group on Infections of the Brain (ESGIB), Basel, Switzerland.
Uta Meyding-LamadeDepartment of Neurology and Epileptology, Hospital Nordwest Frankfurt, Frankfurt, Germany.ORCID https://orcid.org/0000-0003-4692-8843
Ava EastonDepartment of Clinical Infection, Microbiology & Immunology, Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Liverpool, UK.
Bhagteshwar SinghDepartment of Clinical Infection, Microbiology & Immunology, Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Liverpool, UK.
Tom SolomonDepartment of Clinical Infection, Microbiology & Immunology, Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Liverpool, UK.

Funding

European Academy of NeurologyEuropean Society of Clinical Microbiology and Infectious Diseases
6 · The paper itself

Abstract

backgroundEncephalitis is difficult to diagnose and manage, posing a challenge to clinicians. Since the last European guidelines were published in 2010, novel causes have emerged, diagnostic processes have evolved and treatments assessed which need to be reflected in updated guidelines.

objectiveWe aimed to produce recommendations for the diagnosis and management of infectious encephalitis in adults based on current evidence to equip clinicians to improve patient outcomes.

methodsThese guidelines were developed jointly with the support of two European specialist medical organisations. Clinical questions were prioritised and formulated in PICO format. A systematic literature search was conducted for each question, and the quality of evidence was assessed using standardised tools. Recommendations were developed according to the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) approach. Where only indirect evidence was available, a good practice statement was made.

resultsSixteen questions were considered, with two recommendations reached: for initiation of intravenous aciclovir as soon as possible upon suspicion of encephalitis and against replacing pathogen-specific polymerase chain reaction (PCR) testing of cerebrospinal fluid (CSF) with multiplex CSF PCR panels for diagnosis of adult patients with suspected infectious encephalitis. For adults with proven HSV encephalitis, we were unable to recommend for or against the use of corticosteroids. A further 13 good practice statements regarding when to clinically suspect infectious encephalitis, microbiological investigations, additional investigations, treatment and ongoing care and rehabilitation were agreed.

conclusionsGiven the clinical severity and public health importance of this condition, the paucity of high-quality evidence is striking. Transnational, large-scale research in infective encephalitis is encouraged.

Indexed as

Infectious EncephalitisNeurologyAdultEuropeHumansencephalitisGRADEinterventionneurologypractice guidelines

Identifiers

PMID42851210
PMCPMC13650609

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.