Brain inflammation secondary to encephalitis is an urgent global emergency and presents multiple opportunities to reduce current substantial morbidity and mortality. Aetiologies can be divided into infectious and autoimmune causes. In this Seminar, we highlight pragmatic clinical approaches to recognise and distinguish the most common pathogenic viruses and emerging range of autoantibodies encountered in routine practice. These pre-test impressions are judiciously shaped by valuable, simple investigations-particularly serum and cerebrospinal fluid nucleic acid and autoantibody testing-to identify the precise causative agent. This clinically led approach ensures early recognition of encephalitis subtypes, facilitates the timely administration of antivirals and immunotherapies proven to improve patient outcomes, and minimises the frequent misdiagnosis of autoimmune encephalitis. Finally, we review emerging targeted therapeutic approaches, measurements of clinical encephalitis outcomes, and environmental and vaccine-centred strategies to improve prevention, diagnosis, and care for patients with encephalitis, cognisant of long-term patient, caregiver, and economic burdens.

Adding ibrutinib to standard, first-line immunochemotherapy improves failure-free survival in adult patients aged 18-65 years with mantle cell lymphoma, according to the first results from the TRIANGLE trial. With prolonged follow-up, we investigated whether the addition of autologous stem-cell transplantation (ASCT) to an ibrutinib-containing regimen improves failure-free survival, and evaluated effects on overall survival.

Estimates of vaccine impact have typically been used to quantify the effects of, and inform, immunisation strategies. Given the growing resource constraints on health systems worldwide, robust estimates of vaccine impact that allow comparison across different vaccines are now more crucial for decision making than ever. Building on previous modelling studies, we aimed to estimate vaccine impact ratios for an expanded portfolio of Gavi, the Vaccine Alliance-supported vaccination programmes against 14 vaccine-preventable diseases across 117 low-income and middle-income countries using multiple models.

Nacubactam (OP0595) is a newly developed diazabicyclooctane β-lactamase inhibitor used in combination with cefepime or aztreonam. We assessed the efficacy and safety of cefepime-nacubactam and aztreonam-nacubactam versus imipenem-cilastatin in complicated urinary tract infection (cUTI) or acute uncomplicated pyelonephritis.