Dr Oli: Diving and viral encephalitis

Q: Following some bad headaches, high temperatures and confusion I was recently admitted into hospital, and ended up being diagnosed with unspecified viral encephalitis. I had a lot of tests including all the scans and the lumber punch. I was in the hospital for four days. Two weeks after discharge I had an appointment to go back for results and was told that all the tests that were done came back as negative. I went to go on a dive with my club last week and was told that I would not be able to dive until I have a certificate of fitness to dive. I have also got a liveaboard booked and paid for next month that I would hate to miss out on. So what are the chances of me getting wet again?

A: First of all I must ask you about the "lumber punch" - were you actually struck with a wooden plank as a test for encephalitis?! I wonder perhaps if you are referring to a "lumbar puncture", traditionally a more useful investigation, although probably equally as painful. I'm glad in any case that all your tests were clear. To explain: encephalitis is an inflammation of the brain itself, usually viral in origin. It is a very serious illness, potentially life-threatening, and often leaves survivors with variable degrees of brain damage. Being viral, antibiotics are ineffective, but sometimes aciclovir is used, particularly as herpes simplex (the cold sore virus) is the commonest cause of viral encephalitis in the UK. Otherwise treatment is supportive: oxygen, fluids, anticonvulsants and keeping the temperature down whilst the immune system does its best.

I think fitness to dive would very much depend on the presence and extent of any complications following recovery. These can include problems with balance, co-ordination, dexterity, speech, swallowing, movement, concentration, mood, behaviour, memory, seizures. the list is seemingly endless. Each case would therefore have to be considered carefully and individually, but if there is no evidence of any complications, then I don't see why diving should not be possible. When you are fully recovered and discharged from hospital follow-up, pop in for a "fit to dive" medical and we'll give you the complete assessment. And I most definitely will not assault you with a piece of wood (no follow up lumber punch required, I promise).

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