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Central nervous system infections

Overview

CNS infections are the infections affecting the brain, spinal cord, or their covering (meninges). These can be caused by bacteria, fungi, viruses, and parasites. They are more commonly seen in immunocompromised individuals and also in immunocompetent persons.

  • Bacteria- streptococcus pneumoniae, H. influenzae, mycobacterium tuberculosis
  • Viruses- enterovirus, herpesvirus
  • Fungi- candida, aspergillus, cryptococcus
  • Parasites- plasmodium, toxoplasma and others

  • Preexisting conditions like diabetes, liver cirrhosis, stroke, and chronic alcohol abuse
  • Head trauma and injuries to the spinal cord
  • Extrinsic contamination during neurosurgical procedures, cerebrospinal fluid leakage, and drainage tube placement
  • Immunocompromised states including end-stage HIV, systemic chemotherapy, and hereditary immunologic disorders
  • Other factors including congenital malformations, implanted medical devices, and breaches of the blood-brain barrier

  • Fever
  • Headache
  • Stiff neck
  • Altered sensorium
  • Seizures
  • Paralysis

Neurologist

  • Blood tests- abnormal WBC count, blood cultures
  • CSF examination- altered cell count, protein and sugar ratio.
  • MRI/ CT scan

  • Antimicrobial therapy (antibacterial/ antiviral/ antifungal)
  • Supportive care (fluid and pain management)
  • Surgery is sometimes warranted in case of mass effect caused due to abscess
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