Skip to main content
SpringerLink
Log in

Infections of the Central Nervous System

  • Chapter
  • First Online:
Management of Antimicrobials in Infectious Diseases

Part of the book series: Infectious Disease ((ID))

  • 1726 Accesses

Abstract

Infections of the nervous system can be devastating. Their diagnosis and treatment are often challenging, resulting in high rates of morbidity and mortality. Early diagnosis and aggressive treatment can have a significant impact on the outcome. For patients in whom the clinical and radiological features are not characteristic, diagnosis may require high-volume spinal taps and for some, brain and/or meningeal biopsies may be necessary. In infections where the brain is involved secondary to a systemic infection, the drug choice needs to be optimized to include agents that can easily penetrate the blood–brain barrier. Bacterial resistance, especially for pneumococci, has necessitated new approaches to the therapeutic strategies in meningitis. Preventative vaccines have significantly decreased the incidence of Haemophilus influenzae meningitis.

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 269.00
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 219.99
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

References

  1. Antal EA, Dietrichs E, Loberg EM et al. (2005). Brain stem encephalitis in listeriosis. Scand J Infect Dis 37:190–194

    Article  PubMed  Google Scholar 

  2. Berger J (1991). Benign aseptic (Mollaret’s) meningitis after genital herpes. Lancet 337:1360–1361

    Article  PubMed  CAS  Google Scholar 

  3. Fiore AE, Moroney JF, Farley MM et al. (2000). Clinical outcomes of meningitis caused by Streptococcus pneumoniae in the era of antibiotic resistance. Clin Infect Dis 30:71–77

    Article  PubMed  CAS  Google Scholar 

  4. Pediatrics AAo (2006). Haemophilus influenzae Infections. In: Pediatrics AAo, (ed). Red Book: 2006 Report of the Committee on Infectious Diseases, 27th ed. IL:Elk Grove

    Google Scholar 

  5. Bogaerts J, Rouvroy D, Taelman H et al. (1999). AIDS-associated cryptococcal meningitis in Rwanda (1983–1992): Epidemiologic and diagnostic features. J Infect 39:32–37

    Article  PubMed  CAS  Google Scholar 

  6. Folgueira L, Delgado R, Palenque E et al. (1994). Noriega AR. Polymerase chain reaction for rapid diagnosis of tuberculous meningitis in AIDS patients [see comments]. Neurology 44:1336–1338

    PubMed  CAS  Google Scholar 

  7. Macher A, Goosby E, Beller M (1995). PCR and the misdiagnosis of active tuberculosis [letter; comment] [published erratum appears in N Engl J Med 1995 Apr 13; 332(15):1043]. N Engl J Med 332:128–129

    Article  PubMed  CAS  Google Scholar 

  8. Saag MS, Cloud GA, Graybill JR et al. (1999). A comparison of itraconazole versus fluconazole as maintenance therapy for AIDS-associated cryptococcal meningitis. National Institute of Allergy and Infectious Diseases Mycoses Study Group [see comments]. Clin Infect Dis 28:291–296

    Article  PubMed  CAS  Google Scholar 

  9. Lu CH, Chang WN, Chang HW (1999). The prognostic factors of cryptococcal meningitis in HIV-negative patients. J Hosp Infect 42:313–320

    Article  PubMed  CAS  Google Scholar 

  10. Robinson PA, Bauer M, Leal MA et al. (1999). Early mycological treatment failure in AIDS-associated cryptococcal meningitis. Clin Infect Dis 28:82–92

    Article  PubMed  CAS  Google Scholar 

  11. Treatment of tuberculosis (2003). MMWR Recomm Rep 52:1–77

    Google Scholar 

  12. American Academy of Pediatrics Committee on Infectious Diseases (1992). Chemotherapy for tuberculosis in infants and children. Pediatrics 89:161–165

    Google Scholar 

  13. Kaojarern S, Supmonchai K, Phuapradit P et al. (1991). Effect of steroids on cerebrospinal fluid penetration of antituberculous drugs in tuberculous meningitis. Clin Pharmacol Ther 49:6–12

    Article  PubMed  CAS  Google Scholar 

  14. Center for Disease Control (1989). Sexually transmitted diseases treatment guidelines. MMWR 38(suppl 8):9

    Google Scholar 

  15. Emskotter T, Jenzevski H, Pulz M et al. (1988). Neurosyphilis in HIV infection – persistence after high-dose penicillin therapy. J Neuroimmunol 20:153–155

    Article  PubMed  CAS  Google Scholar 

  16. Marra CM, Longstreth WT, Jr., Maxwell CL et al. (1996). Resolution of serum and cerebrospinal fluid abnormalities after treatment of neurosyphilis. Influence of concomitant human immunodeficiency virus infection. Sex Transm Dis 23:184–189

    Article  PubMed  CAS  Google Scholar 

  17. Pfister HW, Preac-Mursic V, Wilske B et al. (1989). Cefotaxime vs penicillin G for acute neurologic manifestations in Lyme borreliosis. A prospective randomized study. Arch Neurol 46:1190–1194

    PubMed  CAS  Google Scholar 

  18. Logigian EL, Kaplan RF, Steere AC (1999). Successful treatment of Lyme encephalopathy with intravenous ceftriaxone. J Infect Dis 180:377–383

    Article  PubMed  CAS  Google Scholar 

  19. Kohlhepp W, Oschmann P, Mertens HG (1989). Treatment of Lyme borreliosis. Randomized comparison of doxycycline and penicillin G. J Neurol 236:464–469

    Article  PubMed  CAS  Google Scholar 

  20. Dotevall L, Hagberg L (1999). Successful oral doxycycline treatment of Lyme disease-associated facial palsy and meningitis. Clin Infect Dis 28:569–574

    Article  PubMed  CAS  Google Scholar 

  21. Loewen PS, Marra CA, Marra F (1999). Systematic review of the treatment of early Lyme disease. Drugs 57:157–173

    Article  PubMed  CAS  Google Scholar 

  22. Kramer LD, Styer LM, Ebel GD (2008). A global perspective on the epidemiology of West Nile virus. Annu Rev Entomol 53:61–81

    Article  PubMed  CAS  Google Scholar 

  23. Keating MR (1999). Antiviral agents for non-human immunodeficiency virus infections. Mayo Clin Proc 74:1266–1283

    Article  PubMed  CAS  Google Scholar 

  24. Berger JR, Major EO (1999). Progressive multifocal leukoencephalopathy. Semin Neurol 19:193–200

    Article  PubMed  CAS  Google Scholar 

  25. Letendre S, Marquie-Beck J, Capparelli E et al. (2008). Validation of the CNS penetration-effectiveness rank for quantifying antiretroviral penetration into the central nervous system. Arch Neurol 65:65–70

    Article  PubMed  Google Scholar 

  26. Levy RM, Major E, Ali MJ et al. (2001). Convection-enhanced intraparenchymal delivery (CEID) of cytosine arabinoside (AraC) for the treatment of HIV-related progressive multifocal leukoencephalopathy (PML). J Neurovirol 7:382–385

    Article  PubMed  CAS  Google Scholar 

  27. Anlar B, Yalaz K, Kose G et al. (1998). Beta-interferon plus inosiplex in the treatment of subacute sclerosing panencephalitis. J Child Neurol 13:557–559

    Article  PubMed  CAS  Google Scholar 

  28. Bouwman FH, Skolasky RL, Hes D et al. (1998). Variable progression of HIV-associated dementia. Neurology 50:1814–1820

    PubMed  CAS  Google Scholar 

  29. Halperin JJ, Shapiro ED, Logigian E et al. (2007). Practice parameter: Treatment of nervous system Lyme disease (an evidence-based review): Report of the Quality Standards Subcommittee of the American Academy of Neurology. Neurology 69:91–102

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Division of Neuroimmunology and Neuroinfectious Disease, Johns Hopkins Department of Neurology, Baltimore, MD, USA

    Nicoline Schiess

  2. Director Division of Neuroimmunology and Neurological infections, Departments of Neurology and Neuroscience, Baltimore, MD, USA

    Avindra Nath

Authors
  1. Nicoline Schiess
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Avindra Nath
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Nicoline Schiess .

Editor information

Editors and Affiliations

  1. Dept. Family Medicine, Medical University of South Carolina, Calhoun St. 295, Charleston, 29425, U.S.A.

    Arch G. Mainous III

  2. School of Medicine, University of California, Davis, Davis, 95616, U.S.A.

    Claire Pomeroy

Rights and permissions

Reprints and permissions

Copyright information

© 2010 Springer Science+Business Media, LLC

About this chapter

Cite this chapter

Schiess, N., Nath, A. (2010). Infections of the Central Nervous System. In: Mainous III, A., Pomeroy, C. (eds) Management of Antimicrobials in Infectious Diseases. Infectious Disease. Humana Press. https://doi.org/10.1007/978-1-60327-239-1_14

Download citation

  • DOI: https://doi.org/10.1007/978-1-60327-239-1_14

  • Published:

  • Publisher Name: Humana Press

  • Print ISBN: 978-1-60327-238-4

  • Online ISBN: 978-1-60327-239-1

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation