Skip to main content Accessibility help
×
Hostname: page-component-78c5997874-94fs2 Total loading time: 0 Render date: 2024-11-02T19:04:06.709Z Has data issue: false hasContentIssue false

11 - Central Nervous System Infections in Adults

from SECTION III - SPECIFIC NEUROLOGICAL CONDITIONS

Published online by Cambridge University Press:  06 August 2009

Oliver W. Hayes
Affiliation:
Ingham Regional Medical Center Sparrow Hospital/MSU Emergency Medicine Residency Program Lansing, Michigan
Earl J. Reisdorff
Affiliation:
Ingham Regional Medical Center Sparrow Hospital/MSU Emergency Medicine Residency Program Lansing, Michigan
Paul Blackburn
Affiliation:
Maricopa Medical Center Phoenix, Arizona
Anthony Briningstool
Affiliation:
Sparrow/MSU Emergency Medicine Residency Program Lansing, Michigan
Sid M. Shah
Affiliation:
Michigan State University
Kevin M. Kelly
Affiliation:
Drexel University, Philadelphia
Get access

Summary

Central nervous system (CNS) infections range from rapidly fatal bacterial meningitis to slowly progressive infectious processes from mycobacterial, fungal, or viral agents. The diagnosis of acute bacterial meningitis is made by the examination of cerebrospinal fluid (CSF). Brain abscess is a suppurative infection involving brain parenchyma. Although the CNS infections most commonly associated with HIV infection are toxoplasmosis and cytomegalovirus (CMV), such patients are susceptible to many other infections including aseptic meningitis, neurosyphilis, and M. tuberculosis. The term aseptic meningitis has been used to describe conditions of acute meningeal irritation that prove to be benign and self-limiting. The incidence of tuberculosis (TB) is on the rise, due to an increase in numbers of HIV-infected persons, numbers of homeless individuals, and immigrants from developing countries. Cryptococcus neoformans, a common fungal pathogen, commonly affects HIV infected patients. Viral encephalitis is an infectious and inflammatory process involving the brain.
Type
Chapter
Information
Principles and Practice of Emergency Neurology
Handbook for Emergency Physicians
, pp. 113 - 130
Publisher: Cambridge University Press
Print publication year: 2003

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Alzeer, A H, FitzGerald, J M. Corticosteroids and tuberculosis: risks and adjunct therapy. Tuber Lung Dis. 1993; 74: 6–11CrossRefGoogle ScholarPubMed
Anderson, M. Management of cerebral infection. J Neurol Neurosurg Psychiatry. 1993; 56: 1243–58CrossRefGoogle ScholarPubMed
Arndt, C A, Walsh, T J, McCully, C L, et al. Fluconazole penetration into cerebrospinal fluid: implications for treating fungal infections of the central nervous system. J Infect Dis. 1988; 157: 178–80CrossRefGoogle ScholarPubMed
Ashwal, S. Neurologic evaluation of the patient with acute bacterial meningitis. Neurol Clin. 1995; 13: 549–77CrossRefGoogle ScholarPubMed
Berenguer, J, Moreno, S, Laguna, F, et al. Tuberculous meningitis in patients infected with the human immunodeficiency virus. N Engl J Med. 1992; 1326: 668–72CrossRefGoogle Scholar
Castro, C, Barros, N, Campos, Z, et al. CT scans of cranial tuberculosis. Radiol Clin North Am. 1995; 33: 753–69Google ScholarPubMed
Centers for Disease Control. Bacterial meningitis & meningococcemia. United States, 1978. MMWR. 1979; 28: 277
The choice of antibacterial drugs. Med Lett Drugs Ther. 1994; 36: 53–60
Chuck, S L, Sande, M A. Infections with cryptococcus neoforms in the acquired immunodeficiency syndrome. N Engl J Med. 1989; 321: 794–9CrossRefGoogle Scholar
Connolly, K J, Hammer, S M. The acute aseptic meningitis syndrome. Infect Dis Clin North Am. 1990; 4: 599–619Google ScholarPubMed
Corson, A P, Chretien, J H. Metronidazole-associated aspetic meningitis. Clin Infect Dis. 1994; 19: 974CrossRefGoogle Scholar
Coyle, P K, Deng, Z, Schutzer, S E, et al. Detection of borrelia burgdorferi antigens in cerebrospinal fluid. Neurology. 1993; 43: 1093CrossRefGoogle ScholarPubMed
Davis, L E, Schmitt, J W. Clinical significance of cerebrospinal fluid tests for neurosyphilis. Ann Neurol. 1989; 25: 50–5CrossRefGoogle ScholarPubMed
Dismukes, W E. Cryptococcal meningitis in patients with AIDS. J Infect Dis. 1988; 157: 624–8CrossRefGoogle ScholarPubMed
Drug-resistant Streptococcus pneumoniae – Kentucky and Tennessee, 1993. MMWR. 1994; 43: 23–31
Duttwyler, R J, Volkman, D J, Conaty, S M, et al. Amoxicillin plus probenecid versus doxycycline for treatment of erythema migrans borreliosis. Lancet. 1990; 336: 1404CrossRefGoogle Scholar
Feldman, H A. Epidemiology of toxoplasma infections. Epidemiol Rev. 1982; 4: 204–13CrossRefGoogle ScholarPubMed
Grant, I H, Gold, J W M, Rosenblum, M, et al. 1990. Toxoplasma gondii serology in HIV infected patients: the development of central nervous system toxoplasmosis in AIDS. AIDS. 1990; 4: 519–21CrossRefGoogle Scholar
Greelee, J E. Approach to diagnosis of meningitis: cerebrospinal fluid evaluation. Infect Dis Clin North Am. 1990; 4: 583–95Google Scholar
Halperin, J J, Volkman, D J, Luft, B J, et al. CTS in Lyme borreliosis. Muscle Nerve. 1989; 12: 397CrossRefGoogle Scholar
Hasso, A N. Current status of enhanced magnetic resonance imaging in neuroradiology. Invest Radiol. 1993; 28(suppl 1): S3–S20CrossRefGoogle ScholarPubMed
Hoeprich P D, Jordan M C, Ronald A R, eds. Infectious Diseases: A Treatise of Infectious Processes, 5th ed. Philadelphia, Pa: Lippincott; 1994
Kovacs, J A, Kovacs, A A, Polis, M, et al. Cryptococcosis in the acquired immunodeficiency syndrome. Ann Intern Med. 1985; 103: 533–8CrossRefGoogle ScholarPubMed
Lamonte, M, Silberstein, S D, Marcelis, J F. Headache associated with aseptic meningitis. Headache. 1995; 35: 520–6CrossRefGoogle ScholarPubMed
Larsen, R A, Bozzette, S A, Jones, B E, Haghigh, D. Fluconazole combined with flucytosine for treatment of cryptococcal meningitis in patients with AIDS. Clin Infect Dis. 1994; 19: 714–5CrossRefGoogle ScholarPubMed
Larsen, R A, Bozzette, S, McCutchan, J A. Persistent cryptococcus neoformans infection of the prostate after successful treatment of meningitis. Ann Intern Med. 1989; 111: 125–8CrossRefGoogle ScholarPubMed
Leonard, J M, Des Perez, R. Tuberculous meningitis. Infect Dis Clin North Am. 1990; 4: 769–87Google ScholarPubMed
Marinac, J S. Drug and chemical-induced aseptic meningitis: a review of the literature. Ann Pharmacother. 1992; 26: 813–22CrossRefGoogle ScholarPubMed
Mischel, P S, Vinters, H V. Coccidioidomycosis of the central nervous system: neuropathological and vasculopathic manifestations and clinical correlates. Clin Infect Dis. 1995; 2: 400–5CrossRefGoogle Scholar
Nguyen, N M, Yu, V L. Meningitis caused by candidal species: an emerging problem in neurosurgical patients. Clin Infect Dis. 1995; 21: 323–7CrossRefGoogle ScholarPubMed
Peters, M, Timm, U, Schurmann, D, et al. Combined and alternating gangcyclovir and foscarnet in acute and maintenance therapy of human immunodeficiency virus-related cytomegalovirus encephalitis refractory to gangyclovir alone. Clin Invest Med. 1992; 70: 456–8Google Scholar
Porter, S B, Sande, M A. Toxoplasmosis of the central nervous system in the acquired immunodeficiency syndrome. N Engl J Med. 1992; 327: 1643–8CrossRefGoogle ScholarPubMed
Ragland, A S, Arsura, E, Ismail, Y, Johnson, R. Eosinophilic pleocytosis in coccidioidal meningitis: frequency and significance. Am J Med. 1993; 95: 254–7CrossRefGoogle ScholarPubMed
Rousseaux, M, Lesoin, F, Destee, A, Jomin, M, Petit, H. Developments in the treatment and prognosis of multiple brain abscesses. Neurosurgery. 1985; 16: 304–8CrossRefGoogle Scholar
Saag, M S, Powderly, W G, Cloud, G A, et al. Comparison of amphotericin B with fluconazole in the treatment of acute AIDS-associated cryptococcal meningitis. N Engl J Med. 1992; 326: 88–9CrossRefGoogle ScholarPubMed
Schenk, D N, Hood, E W. Neurosyphilis. Infect Dis Clin North Am. 1994; 8: 769–95Google Scholar
Scribner, C L, Kapti, R M, Phillips, E T, Rickles, N M. Aseptic Meningitis and intravenous immunoglobulin therapy. Ann Intern Med. 1994; 121: 305–6CrossRefGoogle ScholarPubMed
Schroth, G, Kretzschmar, K, Gawehn, J, Voigt, K. Advantage of magnetic resonance imaging in the diagnosis of cerebral infections. Neuroradiology. 1987; 29: 120–6CrossRefGoogle Scholar
Segreti, J, Harris, A A. Acute bacterial meningitis. Infect Dis Clin North Am. 1996; 10: 797–809CrossRefGoogle ScholarPubMed
Sekul, E A, Cupler, E J, Daladas, M C. Aseptic meningitis associated with high-dose intravenous immunoglobulin therapy: frequency and risk factors. Ann Intern Med. 1994; 121: 259–62CrossRefGoogle ScholarPubMed
Simon, R P. Neurosyphilis. Arch Neurol. 1985; 42: 606–13CrossRefGoogle ScholarPubMed
Torre-Cisneros, J, Lopez, O L, Kusne, S, et al. CNS aspergillosis in organ transplantation: a clinicopathologic study. J Neurol Neurosurg Psychiatry. 1993; 56: 188–93CrossRefGoogle Scholar
Tunkel, A R, Wispelwey, B, Scheld, W M. Pathogenesis and pathophysiology of meningitis. Infect Dis Clin North Am. 1990; 4: 555–75Google ScholarPubMed
Villoria, M F, Torre, J, Fortea, F, et al. Intracranial tuberculosis in AIDS: CT and MRI findings. Neuroradiology. 1992; 34: 11–14CrossRefGoogle ScholarPubMed
Vincent, T, Galgiani, J N, Huppert, M, Salkin, D. The natural history of coccidioidal meningitis: VA-armed forced cooperative studies, 1955–1958. Clin Infect Dis. 1993; 16: 247–54CrossRefGoogle Scholar
Zuger, A, Louie, E, Holzman, R S, Simberkoff, M S, Rahal, J J. Cryptococcal disease in patients with the acquired immunodeficiency syndrome. Diagnostic features and outcome of treatment. Ann Intern Med. 1986; 104: 234–40CrossRefGoogle ScholarPubMed

Save book to Kindle

To save this book to your Kindle, first ensure [email protected] is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

  • Central Nervous System Infections in Adults
    • By Oliver W. Hayes, Ingham Regional Medical Center Sparrow Hospital/MSU Emergency Medicine Residency Program Lansing, Michigan, Earl J. Reisdorff, Ingham Regional Medical Center Sparrow Hospital/MSU Emergency Medicine Residency Program Lansing, Michigan, Paul Blackburn, Maricopa Medical Center Phoenix, Arizona, Anthony Briningstool, Sparrow/MSU Emergency Medicine Residency Program Lansing, Michigan
  • Edited by Sid M. Shah, Michigan State University, Kevin M. Kelly, Drexel University, Philadelphia
  • Book: Principles and Practice of Emergency Neurology
  • Online publication: 06 August 2009
  • Chapter DOI: https://doi.org/10.1017/CBO9780511547256.012
Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

  • Central Nervous System Infections in Adults
    • By Oliver W. Hayes, Ingham Regional Medical Center Sparrow Hospital/MSU Emergency Medicine Residency Program Lansing, Michigan, Earl J. Reisdorff, Ingham Regional Medical Center Sparrow Hospital/MSU Emergency Medicine Residency Program Lansing, Michigan, Paul Blackburn, Maricopa Medical Center Phoenix, Arizona, Anthony Briningstool, Sparrow/MSU Emergency Medicine Residency Program Lansing, Michigan
  • Edited by Sid M. Shah, Michigan State University, Kevin M. Kelly, Drexel University, Philadelphia
  • Book: Principles and Practice of Emergency Neurology
  • Online publication: 06 August 2009
  • Chapter DOI: https://doi.org/10.1017/CBO9780511547256.012
Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

  • Central Nervous System Infections in Adults
    • By Oliver W. Hayes, Ingham Regional Medical Center Sparrow Hospital/MSU Emergency Medicine Residency Program Lansing, Michigan, Earl J. Reisdorff, Ingham Regional Medical Center Sparrow Hospital/MSU Emergency Medicine Residency Program Lansing, Michigan, Paul Blackburn, Maricopa Medical Center Phoenix, Arizona, Anthony Briningstool, Sparrow/MSU Emergency Medicine Residency Program Lansing, Michigan
  • Edited by Sid M. Shah, Michigan State University, Kevin M. Kelly, Drexel University, Philadelphia
  • Book: Principles and Practice of Emergency Neurology
  • Online publication: 06 August 2009
  • Chapter DOI: https://doi.org/10.1017/CBO9780511547256.012
Available formats
×