Neuro-Infectious Disorders of Childhood

Abstract

Children can be affected by the same or similar neuro-infectious disorders as adults. However, there are some neuro-infections that significantly differ between children and adults and/or between children of different age ranges in regard to the imaging pattern, the infectious agent and/or the route of infection. These include neuro-infectious diseases acquired in utero, neonatally, or during childhood and adolescence. Classic congenital, i.e., in utero acquired, are summarized in the so-called TORCH group, which stand for TOxoplasmosis, Rubella, Cytomegalovirus (CMV), and Herpes simplex virus (HSV) type II. These congenital infections have a characteristic imaging appearance that significantly differs from infections acquired later in life. Other congenital infections include lymphocytic choriomeningitis (LCM), syphilis, and HIV. Viral infections of the brain that preferentially affect children or those have a characteristic imaging appearance in childhood are the Rasmussen encephalitis, Subacute Sclerosing Panencephalitis (SSPE) as a complication of measles, the Reye syndrome, and varicella zoster encephalitis. Herpes simplex virus type 1 infections of the brain, tick-born encephalitis, and progressive multifocal leukoencephalitis (PML) may also have a somewhat different appearance, when occurring in childhood. In bacterial encephalitis, it is important to differentiate early and late cerebritis and abscess formation. Mycoplasma encephalitis tends to occur more often in children than in adults. Fungal infections of the brain usually only manifest themselves in the immunosuppressed child. They include candida and cryptococcal infections and coccidioidosis. Cysticercosis is a comparatively common parasitic infection of the brain that occurs both in children and in adults. Neuro-infectious diseases in childhood can have a variety of causes, including bacterial, viral, fungal and parasitic organisms. In addition to the type of infectious agent, pediatric neuro-infections are typically classified according to the age, at which infection occurred: congenital infections, i.e., in utero infections of the brain during embryonic and fetal development neonatal infections, i.e., infections that were either acquired perinatally or in the directly postnatal period infections that were acquired during the further course of childhood and adolescence.