Skip to main content
SpringerLink
Log in

Infections of the Central Nervous System

  • Chapter
Critical Care Neurology and Neurosurgery

Part of the book series: Current Clinical Neurology ((CCNEU))

  • 313 Accesses

Abstract

The central nervous system (CNS) is typically regarded as a privileged environment in the human body because of the innate protection afforded by the blood brain barrier. Nevertheless, various microbial pathogens are capable of infecting the nervous system, particularly in the immunocompromised host. Generally, CNS infections can be broadly categorized into infections of the meninges (meningitis), parenchyma (encephalitis), abscesses, granulomatous infections, and fungal infections. This chapter covers the epidemiology, diagnosis, pathophysiology, treatment, and outcome of these general categories of CNS infections.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 169.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 219.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 299.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Coyle PK. Overview of acute and chronic meningitis. Neurol. Clin. 1999; 17: 691–710.

    Article  PubMed  CAS  Google Scholar 

  2. Durand ML, Calderwood SB, Weber DJ, et al. Acute bacterial meningitis in adults: A review of 493 episodes. N. Engl. J. Med. 1993; 328: 21–28.

    Article  PubMed  CAS  Google Scholar 

  3. Hussein AS, Shafran SD. Acute bacterial meningitis in adults: A 12 year review. Medicine (Baltimore) 2000; 79: 360–368.

    Article  CAS  Google Scholar 

  4. Schuchat A, Robinson K, Wenger JD, et al. Bacterial meningitis in the United States in 1995. N. Engl. J. Med. 1997; 337: 970–976.

    Article  PubMed  CAS  Google Scholar 

  5. Quagliarello VJ, Scheld WM. Treatment of bacterial meningitis. N. Engl. J. Med. 1997; 336: 708–716.

    Article  PubMed  CAS  Google Scholar 

  6. Rajnik M, Ottolini MG. Serious infections of the central nervous system: Encephalitis, meningitis, and brain abscess. Adol. Med. 2001; 11: 401–425.

    Google Scholar 

  7. Spach DH, Jackson LA. Bacterial meningitis. Neurol. Clin. 1999; 17: 711–735.

    Article  PubMed  CAS  Google Scholar 

  8. Roos KL, Scheld WM. The management of fulminant meningitis in the intensive care unit. Infect. Dis. Clin. North Am. 1989; 3: 137–152.

    PubMed  CAS  Google Scholar 

  9. Hasbun R, Abrahams J, Jekel J, Quagliarello VJ. Computed tomography of the head before lumbar puncture in adults with suspected meningitis. N. Engl. J. Med. 2001; 345: 1727–1733.

    Article  PubMed  CAS  Google Scholar 

  10. Zunt JR, Marra CM. Cerebrospinal fluid testing for the diagnosis of central nervous system infection. Neurol. Clin. 1999; 17: 675–689.

    Article  PubMed  CAS  Google Scholar 

  11. Wong J, Quint DJ. Imaging of central nervous system infection. Semin. Roentgenol. 1999; 34: 123–143.

    Article  PubMed  CAS  Google Scholar 

  12. Rauf SJ, Roberts NJ. Supportive management in bacterial meningitis. Inf. Dis. Clin. North Am. 1999; 13: 647–659.

    Article  CAS  Google Scholar 

  13. Kilpatrick MM, Lowry DW, Firlik AD, Yonas H, Marion DW. Hyperthermia in the neurosurgical intensive care unit. Neurosurgery 2000; 47: 850–855.

    Article  PubMed  CAS  Google Scholar 

  14. Tunkel AR, Wispelwey B, Scheld WM. Bacterial meningitis: Recent advances in pathophysiology and treatment. Ann. Intern. Med. 1990; 112: 610–623.

    PubMed  CAS  Google Scholar 

  15. Thomas R, Le Tulzo Y, Bouget J, et al. Trial of dexamethasone treatment for severe bacterial meningitis in adults. Intensive Care Med. 1999; 25: 475–480.

    Article  PubMed  CAS  Google Scholar 

  16. Roos KL. Pearls and pitfalls in the diagnosis and management of central nervous system infectious diseases. Semin. Neurol. 1998; 18: 185–196.

    Article  PubMed  CAS  Google Scholar 

  17. Gilbert DN, Moellering RC, Sande MA. The Sanford Guide to Antimicrobial Therapy, 31st ed. Hyde Park, VT: Antimicrobial Therapy, 2001: 2–45.

    Google Scholar 

  18. Roos KL. Encephalitis. Neurol. Clin. 1999; 17: 813–833.

    Article  PubMed  CAS  Google Scholar 

  19. Arboviral infections of the central nervous system—United States, 1996–1997. MMWR 1998; 47: 517–542.

    Google Scholar 

  20. Singh N, Hasain S. Infections of the central nervous system in transplant recipients. Transpl. Infect. Dis. 2000; 2: 101–111.

    Article  PubMed  CAS  Google Scholar 

  21. Akhan SC, Coskunkan F, Mutlu B, Gundes S, Vahaboglu H, Willke A. A probable case of herpes simplex encephalitis despite negative PCR findings. Infection 2001; 29: 359–361.

    Article  PubMed  CAS  Google Scholar 

  22. Schmutzhard E. Viral infections of the CNS with special emphasis on herpes simplex infections. J. Neurol. 2001; 248: 469–477.

    Article  PubMed  CAS  Google Scholar 

  23. Villarreal EC. Current and potential therapies for the treatment of herpes virus infections. Prog. Drug. Res. (Spec) 2001; 185–228.

    Google Scholar 

  24. Strady C, Hung Nguyen V, Jaussaud R, Lang J, Lienard M, Strady A. Pre-exposure rabies vaccination: strategies and cost-minimization study. Vaccine 2001; 19: 11–12.

    Article  Google Scholar 

  25. Wilde H, Khawplod P, Hemachudha T, Sitprija V. Postexposure treatment of rabies infection: Can it be done without immunoglobulin ? Clin. Infect. Dis. 2001; 34: 477–480.

    Article  Google Scholar 

  26. Mathiesen GE, Johnson JP. Brain abscess. Clin. Infect. Dis. 1997; 25: 763–781.

    Article  Google Scholar 

  27. Calfee DP, Wispelwey B. Brain abscess. Semin. Neurol. 2000; 20: 353–360.

    Article  PubMed  CAS  Google Scholar 

  28. Davis LE, Baldwin NG. Brain abscess. Curr. Treat. Options Neurol. 1999; 1: 157–166.

    Article  PubMed  Google Scholar 

  29. Calfee DP, Wispelwey B. Brain abscess, subdural empyema, and intracranial epidural abscess. Curr. Infect. Dis. Rep. 1999; 1: 166–177.

    Article  PubMed  Google Scholar 

  30. Sarma S, Sekhar LN. Brain-stem abscess successfully treated by microsurgical drainage: a case report. Neurol. Res. 2001; 23: 855–861.

    Article  PubMed  CAS  Google Scholar 

  31. Morris A, Low DE. Nosocomial bacterial meningitis, including central nervous system shunt infections. Infect. Dis. Clin. North Am. 1999; 13: 735–750.

    Article  PubMed  CAS  Google Scholar 

  32. Korinek AM. Risk factors for neurosurgical site infections after craniotomy: A prospective multicenter study of 2944 patients. The French Study Group of Neurosurgical Infections, the SEHP, and the C-CLIN Paris-Nord. Service. Epidemiologie Hygiene et Prevention. Neurosurgery 1997; 41: 1073–1079.

    Article  PubMed  CAS  Google Scholar 

  33. Bell WO. Management of infected cerebrospinal fluid shunts in children. Contemp. Neurosurg. 1992; 14: 6–16.

    Google Scholar 

  34. Winfield JA, Rosenthal P, Kanter RK, Casella G. Duration of intracranial pressure monitoring does not predict daily risk of infectious complications. Neurosurgery 1993; 33: 424–431.

    Article  PubMed  CAS  Google Scholar 

  35. Horgan MA, Piatt JH. Shaving the scalp may increase the rate of infection in CSF shunt surgery. Pediatr. Neurosurg. 1997; 26: 180–184.

    Article  PubMed  CAS  Google Scholar 

  36. Davis LE. Fungal infections of the central nervous system. Neurol. Clin. 1997; 17: 761–782.

    Article  Google Scholar 

  37. Bennett JE. Antimicrobial agents: antifungal agents. In: Hardman JG, Limbird LE, Goodman AG (eds). Goodman and Gilman’s The Pharmacologic Basis of Therapeutics, 10th ed. New York: McGraw-Hill, 2001: 1295–1312.

    Google Scholar 

Download references

Authors
  1. Ronald G. Riechers II
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Abel D. Jarell
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Geoffrey S. F. Ling
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. Neurosciences Critical Care, University Hospitals of Cleveland, Case Western Reserve University, Cleveland, OH, USA

    Jose I. Suarez MD

Rights and permissions

Reprints and permissions

Copyright information

© 2004 Springer Science+Business Media New York

About this chapter

Cite this chapter

Riechers, R.G., Jarell, A.D., Ling, G.S.F. (2004). Infections of the Central Nervous System. In: Suarez, J.I. (eds) Critical Care Neurology and Neurosurgery. Current Clinical Neurology. Humana Press, Totowa, NJ. https://doi.org/10.1007/978-1-59259-660-7_29

Download citation

  • DOI: https://doi.org/10.1007/978-1-59259-660-7_29

  • Publisher Name: Humana Press, Totowa, NJ

  • Print ISBN: 978-1-61737-350-3

  • Online ISBN: 978-1-59259-660-7

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics

Search

Navigation