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Central Nervous System Infection

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Highly Infectious Diseases in Critical Care

Abstract

CNS infections may be the most dramatic diseases in the critical care setting. Bacterial meningitis and viral encephalitis may be rapidly fatal, even in otherwise normal individuals. Survivors may suffer lasting neurological sequelae, including memory loss and seizures. Cases of meningococcal meningitis carry great anxiety in both treating physicians and family contacts. Viral meningitis, by contrast, gives patients a bad headache and a stiff neck, but uneventful recovery is the rule.

Approximately 1.2 million cases of bacterial meningitis occur annually worldwide and lead to approximately 135,000 deaths throughout the world each year.

The presence or absence of normal brain function is the important distinguishing feature between encephalitis and meningitis. In critical care settings in patients with meningitis, their cerebral function remains normal. While in encephalitis, abnormalities in brain function are a differentiating feature, including altered mental status, motor or sensory deficits, altered behavior, personality changes, and speech or movement disorders.

Focal neurological infections like brain abscess and pyogenic infections like subdural empyema can lead to elevated intracranial pressure and have significant morbidity and mortality. Appropriate identification and acute management of these infections through medical and surgical approaches often occurs in the critical care unit and is vital to improving outcome in this group.

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References

  1. Schuchat A, Robinson K, Wenger JK, et al. Bacterial meningitis in the United States in 1995. Active Surveillance Team. N Engl J Med. 1997;337:970–6.

    Article  CAS  PubMed  Google Scholar 

  2. Uchihara T, Tsukagoshi H. Jolt accentuation of headache: the most sensitive sign of CSF pleocytosis. Headache. 1991;31:167.

    Article  CAS  PubMed  Google Scholar 

  3. Thomas KE, Hasbun R, Jekel J, Quagliarello VJ. The diagnostic accuracy of Kernig’s sign, Brudzinski’s sign, and nuchal rigidity in adults with suspected meningitis. Clin Infect Dis. 2002;35:46.

    Article  PubMed  Google Scholar 

  4. Nakao JH, Jafri FN, Shah K, Newman DH. Jolt accentuation of headache and other clinical signs: poor predictors of meningitis in adults. Am J Emerg Med. 2014;32:24.

    Article  PubMed  Google Scholar 

  5. Zoons E, Weisfelt M, de Gans J, et al. Seizures in adults with bacterial meningitis. Neurology. 2008;70:2109.

    Article  CAS  PubMed  Google Scholar 

  6. Kornelisse RF, Westerbeek CM, Spoor AB, et al. Pneumococcal meningitis in children: prognostic indicators and outcome. Clin Infect Dis. 1995;21:1390.

    Article  CAS  PubMed  Google Scholar 

  7. Durand ML, Calderwood SB, Weber DJ, et al. Acute bacterial meningitis in adults. A review of 493 episodes. N Engl J Med. 1993;328:21–8.

    Article  CAS  PubMed  Google Scholar 

  8. Tunkel AR, Hartman BJ, Kaplan SL, et al. Practice guidelines for the management of bacterial meningitis. Clin Infect Dis. 2004;39:1267–84. https://doi.org/10.1086/425368.

    Article  PubMed  Google Scholar 

  9. Brouwer MC, van de Beek D, Heckenberg SG, et al. Community-acquired Listeria monocytogenes meningitis in adults. Clin Infect Dis. 2006;43:1233.

    Article  PubMed  Google Scholar 

  10. Tunkel AR. Approach to the patient with central nervous system infection. In: Bennett JE, Dolin R, Blaser MJ, editors. Principles and practice of infectious diseases. 8th ed. Philadelphia: Elsevier Saunders; 2015. p. 1091.

    Google Scholar 

  11. McGill F, Heyderman RS, Michael BD, et al. The UK joint specialist societies guideline on the diagnosis and management of acute meningitis and meningococcal sepsis in immunocompetent adults. J Infect. 2016;72:405.

    Article  CAS  PubMed  Google Scholar 

  12. Beek D, Gans J, Spanjaard L, Weisfelt M, Reitsma JB, Vermeulen M. Clinical features and prognostic factors in adults with bacterial meningitis. N Engl J Med. 2004;351:1849–59.

    Article  PubMed  Google Scholar 

  13. Scheld WM, Koedel U, Nathan B, Pfister HW. Pathophysiology of bacterial meningitis: mechanism(s) of neuronal injury. J Infect Dis. 2002;186(Suppl 2):S225.

    Article  CAS  PubMed  Google Scholar 

  14. Arditi M, Mason EOJ, Bradley JS, et al. Three-year multicenter surveillance of pneumococcal meningitis in children: clinical characteristics, and outcome related to penicillin susceptibility and dexamethasone use. Pediatrics. 1998;102:1087–97.

    Article  CAS  PubMed  Google Scholar 

  15. Hortal M, Camou T, Palacio R, Dibarbourne H, Garcia A. Ten-year review of invasive pneumococcal diseases in children and adults from Uruguay: clinical spectrum, serotypes, and antimicrobial resistance. Int J Infect Dis. 2000;4:91–5.

    Article  CAS  PubMed  Google Scholar 

  16. Lopez R, Garcia E, Garcia P, Garcia JL. The pneumococcal cell wall degrading enzymes: a modular design to create new lysins. Microb Drug Resist. 1997;3:199–211.

    Article  CAS  PubMed  Google Scholar 

  17. Tuomanen E, Liu H, Hengstler B, Zak O, Tomasz A. The induction of meningeal inflammation by components of the pneumococcal cell wall. J Infect Dis. 1985;151:859–68.

    Article  CAS  PubMed  Google Scholar 

  18. Tuomanen E, Tomasz A, Hengstler B, Zak O. The relative role of bacterial cell wall and capsule in the induction of inflammation in pneumococcal meningitis. J Infect Dis. 1985;151:535–40.

    Article  CAS  PubMed  Google Scholar 

  19. Yoshimura A, Lien E, Ingalls RR, Tuomanen E, Dziarski R. Cutting edge: recognition of gram-positive bacterial cell wall components by the innate immune system occurs via toll-like receptor 2. J Immunol. 1999;163:1–5.

    CAS  PubMed  Google Scholar 

  20. Braun JS, Novak R, Gao G, Murray PJ, Shenep JL. Pneumolysin, a protein toxin of Streptococcus pneumoniae induces nitric oxide production from macrophages. Infect Immun. 1999;67:3750–6.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  21. Friedland IR, Paris MM, Hickey S, et al. The limited role of pneumolysin in the pathogenesis of pneumococcal meningitis. J Infect Dis. 1995;172:805–9.

    Article  CAS  PubMed  Google Scholar 

  22. Medzhitov R. CpG DNA: security code for host defense. Nat Immunol. 2001;2:15–6.

    Article  CAS  PubMed  Google Scholar 

  23. Wagner H. Toll meets bacterial CpG-DNA. Immunity. 2001;14:499–502.

    Article  CAS  PubMed  Google Scholar 

  24. Deng GM, Liu ZQ, Tarkowski A. Intracisternally localized bacterial DNA containing CpG motifs induces meningitis. J Immunol. 2001;167:4616–26.

    Article  CAS  PubMed  Google Scholar 

  25. Chang L, Karin M. Mammalian MAP kinase signaling cascades. Nature. 2001;410:37–40.

    Article  CAS  PubMed  Google Scholar 

  26. Herlaar E, Brown Z. p38 MAPK signaling cascades in inflammatory disease. Mol Med Today. 1999;5:439–47.

    Article  CAS  PubMed  Google Scholar 

  27. Guha M, Mackman N. LPS induction of gene expression in human monocytes. Cell Signal. 2001;13:85–94.

    Article  CAS  PubMed  Google Scholar 

  28. Dziarski R, Jin YP, Gupta D. Differential activation of extra cellular signal-regulated kinase (ERK) 1, ERK2, p38, and c-Jun NH2-terminal kinase mitogen-activated protein kinases by bacterial peptidoglycan. J Infect Dis. 1996;174:777–85.

    Article  CAS  PubMed  Google Scholar 

  29. Shall S, De Murcia G. Poly (ADP-ribose) polymerase-1: what have we learned from the deficient mouse model. Mutat Res. 2000;460:1–15.

    Article  CAS  PubMed  Google Scholar 

  30. Hausmann EH, Berman NE, Wang YY, Meara JB, Wood GW. Selective chemokine mRNA expression following brain injury. Brain Res. 1998;788:49–59.

    Article  CAS  PubMed  Google Scholar 

  31. Kempski O. Cerebral edema. Semin Nephrol. 2001;21:303–7.

    Article  CAS  PubMed  Google Scholar 

  32. Scheld WM, Dacey RC, Winn HR, Welsh JE, Jane JA. Cerebrospinal fluid outflow resistance in rabbits with experimental meningitis. J Clin Invest. 1980;66:243–53.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  33. Kaplan SL. Clinical presentations, diagnosis, and prognostic factors of bacterial meningitis. Infect Dis Clin N Am. 1999;13:579.

    Article  CAS  Google Scholar 

  34. Brouwer MC, van de Beek D, Heckenberg SG, et al. Hyponatraemia in adults with community-acquired bacterial meningitis. QJM. 2007;100:37.

    Article  CAS  PubMed  Google Scholar 

  35. de Gans J, van de Beek D. European dexamethasone in adulthood bacterial meningitis study investigators. Dexamethasone in adults with bacterial meningitis. N Engl J Med. 2002;347:1549.

    Article  PubMed  Google Scholar 

  36. van de Beek D, de Gans J, Spanjaard L, et al. Clinical features and prognostic factors in adults with bacterial meningitis. N Engl J Med. 2004;351:1849.

    Article  PubMed  Google Scholar 

  37. Aronin SI, Peduzzi P, Quagliarello VJ. Community-acquired bacterial meningitis: risk stratification for adverse clinical outcome and effect of antibiotic timing. Ann Intern Med. 1998;129:862.

    Article  CAS  PubMed  Google Scholar 

  38. Geiseler PJ, Nelson KE, Levin S, et al. Community-acquired purulent meningitis: a review of 1,316 cases during the antibiotic era, 1954-1976. Rev Infect Dis. 1980;2:725.

    Article  CAS  PubMed  Google Scholar 

  39. Brouwer MC, Thwaites GE, Tunkel AR, van de Beek D. Dilemmas in the diagnosis of acute community-acquired bacterial meningitis. Lancet. 2012;380:1684.

    Article  PubMed  Google Scholar 

  40. 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.

    Article  CAS  PubMed  Google Scholar 

  41. Kanegaye JT, Soliemanzadeh P, Bradley JS. Lumbar puncture in pediatric bacterial meningitis: defining the time interval for recovery of cerebrospinal fluid pathogens after parenteral antibiotic pretreatment. Pediatrics. 2001;108:1169.

    CAS  PubMed  Google Scholar 

  42. Joffe AR. Lumbar puncture and brain herniation in acute bacterial meningitis: a review. J Intensive Care Med. 2007;22:194.

    Article  PubMed  Google Scholar 

  43. Glimåker M, Sjölin J, Åkesson S, Naucler P. Lumbar puncture performed promptly or after neuroimaging in acute bacterial meningitis in adults: a prospective National Cohort Study Evaluating Different Guidelines. Clin Infect Dis. 2018;66:321.

    Article  PubMed  Google Scholar 

  44. Blazer S, Berant M, Alon U. Bacterial meningitis. Effect of antibiotic treatment on cerebrospinal fluid. Am J Clin Pathol. 1983;80:386.

    Article  CAS  PubMed  Google Scholar 

  45. Fitch MT, van de Beek D. Emergency diagnosis and treatment of adult meningitis. Lancet Infect Dis. 2007;7:191.

    Article  PubMed  Google Scholar 

  46. Saha SK, Darmstadt GL, Yamanaka N, et al. Rapid diagnosis of pneumococcal meningitis: implications for treatment and measuring disease burden. Pediatr Infect Dis J. 2005;24:1093.

    Article  PubMed  Google Scholar 

  47. Spanos A, Harrell FE Jr, Durack DT. Differential diagnosis of acute meningitis. An analysis of the predictive value of initial observations. JAMA. 1989;262:2700.

    Article  CAS  PubMed  Google Scholar 

  48. Huy NT, Thao NT, Diep DT, et al. Cerebrospinal fluid lactate concentration to distinguish bacterial from aseptic meningitis: a systemic review and meta-analysis. Crit Care. 2010;14:R240.

    Article  PubMed  PubMed Central  Google Scholar 

  49. Sakushima K, Hayashino Y, Kawaguchi T, et al. Diagnostic accuracy of cerebrospinal fluid lactate for differentiating bacterial meningitis from aseptic meningitis: a meta-analysis. J Infect. 2011;62:255.

    Article  PubMed  Google Scholar 

  50. Schmidley JW, Simon RP. Postictal pleocytosis. Ann Neurol. 1981;9:81.

    Article  CAS  PubMed  Google Scholar 

  51. Tumani H, Jobs C, Brettschneider J, et al. Effect of epileptic seizures on the cerebrospinal fluid--a systematic retrospective analysis. Epilepsy Res. 2015;114:23.

    Article  CAS  PubMed  Google Scholar 

  52. Tzanakaki G, Tsopanomichalou M, Kesanopoulos K, et al. Simultaneous single-tube PCR assay for the detection of Neisseria meningitidis, Haemophilus influenzae type b and Streptococcus pneumoniae. Clin Microbiol Infect. 2005;11:386.

    Article  CAS  PubMed  Google Scholar 

  53. Werno AM, Murdoch DR. Medical microbiology: laboratory diagnosis of invasive pneumococcal disease. Clin Infect Dis. 2008;46:926.

    Article  PubMed  Google Scholar 

  54. Negrini B, Kelleher KJ, Wald ER. Cerebrospinal fluid findings in aseptic versus bacterial meningitis. Pediatrics. 2000;105:316.

    Article  CAS  PubMed  Google Scholar 

  55. Beek D, Gans J, Tunkel AR, Wijdicks EF. Community-acquired bacterial meningitis in adults. N Engl J Med. 2006;354:44–53.

    Article  PubMed  Google Scholar 

  56. McIntyre PB, Berkey CS, King SM, et al. Dexamethasone as adjunctive therapy in bacterial meningitis. A meta-analysis of randomized clinical trials since 1988. JAMA. 1997;278:925–31.

    Article  CAS  PubMed  Google Scholar 

  57. Gans J, Beek D. Dexamethasone in adults with bacterial meningitis. N Engl J Med. 2002;347:1549–56.

    Article  PubMed  Google Scholar 

  58. Nguyen TH, Tran TH, Thwaites G, et al. Dexamethasone in Vietnamese adolescents and adults with bacterial meningitis. N Engl J Med. 2007;357:2431–40.

    Article  CAS  PubMed  Google Scholar 

  59. Scarborough M, Gordon SB, Whitty CJ, et al. Corticosteroids for bacterial meningitis in adults in sub-Saharan Africa. N Engl J Med. 2007;357:2441–50.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  60. Beek D, Farrar JJ, Gans J, et al. Adjunctive dexamethasone in bacterial meningitis: a meta-analysis of individual patient data. Lancet Neurol. 2010;9:254–63.

    Article  PubMed  PubMed Central  Google Scholar 

  61. Brouwer MC, McIntyre P, de Gans J, Prasad K, van de Beek D. Corticosteroids for acute bacterial meningitis. Cochrane Database Syst Rev. 2010;(9):CD004405.

    Google Scholar 

  62. Brouwer MC, Heckenberg SG, Gans J, Spanjaard L, Reitsma JB, Beek D. Nationwide implementation of adjunctive dexamethasone therapy for pneumococcal meningitis. Neurology. 2010;75:1533–9.

    Article  CAS  PubMed  Google Scholar 

  63. Tenembaum S, Chitnis T, Ness J, Hahn JS. Acute disseminated encephalomyelitis. Neurology. 2007;68(16 Suppl 2):S23–36.

    Article  PubMed  Google Scholar 

  64. Chaudhuri A, Kennedy PG. Diagnosis and treatment of viral encephalitis. Postgrad Med J. 2002;78:575–83.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  65. Petropoulou KA, Gordon SM, Prayson RA, Ruggierri PM. West Nile virus meningoencephalitis: MR imaging findings. AJNR Am J Neuroradiol. 2005;26:1986–95.

    PubMed  Google Scholar 

  66. Ali M, Safriel Y, Sohi J, Llave A, Weathers S. West Nile virus infection: MR imaging findings in the nervous system. AJNR Am J Neuroradiol. 2005;26:289–97.

    PubMed  Google Scholar 

  67. Gilden DH, Mahalingam R, Cohrs RJ, Tyler KL. Herpesvirus infections of the nervous system. Nat Clin Pract Neurol. 2007;3:82–94.

    Article  CAS  PubMed  Google Scholar 

  68. Domingues RB, Tsanaclis AM, Pannuti CS, Mayo MS, Lakeman FD. Evaluation of the range of clinical presentations of herpes simplex encephalitis by using polymerase chain reaction assay of cerebrospinal fluid samples. Clin Infect Dis. 1997;25:86–91.

    Article  CAS  PubMed  Google Scholar 

  69. Domingues RB, Fink MC, Tsanaclis AM, et al. Diagnosis of herpes simplex encephalitis by magnetic resonance imaging and polymerase chain reaction assay of cerebrospinal fluid. J Neurol Sci. 1998;157:148–53.

    Article  CAS  PubMed  Google Scholar 

  70. O'Sullivan CE, Aksamit AJ, Harrington JR, Harmsen WS, Mitchell PS, Patel R. Clinical spectrum and laboratory characteristics associated with detection of herpes simplex virus DNA in cerebrospinal fluid. Mayo Clin Proc. 2003;78:1347–52. https://doi.org/10.4065/78.11.1347.

    Article  PubMed  Google Scholar 

  71. Simko JP, Caliendo AM, Hogle K, Versalovic J. Differences in laboratory findings for cerebrospinal fluid specimens obtained from patients with meningitis or encephalitis due to herpes simplex virus (HSV) documented by detection of HSV DNA. Clin Infect Dis. 2002;35:414–9.

    Article  PubMed  Google Scholar 

  72. Whitley RJ, Soong SJ, Linneman C Jr, Liu C, Pazin G, Alford CA. Herpes simplex encephalitis. Clinical Assessment. JAMA. 1982;247:317–20.

    Article  CAS  PubMed  Google Scholar 

  73. Weil AA, Glaser CA, Amad Z, Forghani B. Patients with suspected herpes simplex encephalitis: rethinking an initial negative polymerase chain reaction result. Clin Infect Dis. 2002;34:1154–7.

    Article  PubMed  Google Scholar 

  74. Solomon T, Hart IJ, Beeching NJ. Viral encephalitis: a clinician's guide. Pract Neurol. 2007;7:288–305.

    Article  PubMed  Google Scholar 

  75. Tunkel AR. Brain abscess. In: Mandell GL, Bennett JE, Dolin R, editors. Principles and practice of infectious diseases. 7th ed. Philidelphia: Churchill-Livingstone; 2010. p. 1265–78.

    Google Scholar 

  76. Kamei S, Sekizawa T, Shiota H, et al. Evaluation of combination therapy using aciclovir and corticosteroid in adult patients with herpes simplex virus encephalitis. J Neurol Neurosurg Psychiatry. 2005;76:1544–9.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  77. Lange N, Berndt M, Jörger AK, Wagner A, Wantia N, Lummel N, Ryang YM, Meyer B, Gempt J. Clinical characteristics and course of primary brain abscess. Acta Neurochir. 2018;160(10):2055–62.

    Article  PubMed  Google Scholar 

  78. Widdrington JD, Bond H, Schwab U, Price DA, Schmid ML, McCarron B, Chadwick DR, Narayanan M, Williams J, Ong E. Pyogenic brain abscess and subdural empyema: presentation, management, and factors predicting outcome. Infection. 2018;46(6):785–92.

    Article  CAS  PubMed  Google Scholar 

  79. Chen M, Low DCY, Low SYY, Muzumdar D, Seow WT. Management of brain abscesses: where are we now? Childs Nerv Syst. 2018;34(10):1871–80.

    Article  PubMed  Google Scholar 

  80. Udayakumaran S, Onyia CU, Kumar RK. Forgotten? not yet. Cardiogenic brain abscess in children: a case series-based review. World Neurosurg. 2017;107:124–9.

    Article  PubMed  Google Scholar 

  81. Gorji GRS, Rassouli M, Staji H. Prevalence of cerebral toxoplasmosis among slaughtered sheep in Semnan, Iran. Ann Parasitol. 2018;64(1):37–42.

    PubMed  Google Scholar 

  82. Maher G, Beniwal M, Bahubali V, Biswas S, Bevinahalli N, Srinivas D, Siddaiah N. Streptococcus pluranimalium: emerging animal streptococcal species as causative agent of human brain abscess. World Neurosurg. 2018;115:208–12.

    Article  PubMed  Google Scholar 

  83. Longo D, Narese D, Fariello G. Diagnosis of brain abscess: a challenge that magnetic resonance can help us win! Epidemiol Infect. 2018;146(12):1608–10.

    Article  PubMed  Google Scholar 

  84. Berndt M, Lange N, Ryang YM, Meyer B, Zimmer C, Hapfelmeier A, Wantia N, Gempt J, Lummel N. Value of diffusion-weighted imaging in the diagnosis of postoperative intracranial infections. World Neurosurg. 2018;118:e245–53.

    Article  PubMed  Google Scholar 

  85. Simjian T, Muskens IS, Lamba N, Yunusa I, Wong K, Veronneau R, Kronenburg A, Brouwers HB, Smith TR, Mekary RA, Broekman MLD. Dexamethasone administration and mortality in patients with brain abscess: a systematic review and meta-analysis. World Neurosurg. 2018;115:257–63.

    Article  PubMed  Google Scholar 

  86. Vieira E, Guimarães TC, Faquini IV, Silva JL, Saboia T, Andrade RVCL, Gemir TL, Neri VC, Almeida NS, Azevedo-Filho HRC. Randomized controlled study comparing 2 surgical techniques for decompressive craniectomy: with watertight duraplasty and without watertight duraplasty. J Neurosurg. 2018;129(4):1017–23.

    Article  PubMed  Google Scholar 

  87. Tunthanathip T, Kanjanapradit K, Sae-Heng S, Oearsakul T, Sakarunchai I. Predictive factors of the outcome and intraventricular rupture of brain abscess. J Med Assoc Thail. 2015;98(2):170–80.

    Google Scholar 

  88. Bonis P, Anile C, Pompucci A, Labonia M, Lucantoni C, Mangiola A. Cranial and spinal subdural empyema. Br J Neurosurg. 2009;23:335–40.

    Article  PubMed  Google Scholar 

  89. Nathoo N, Nadvi SS, Dellen JR. Cranial extradural empyema in the era of computed tomography: a review of 82 cases. Neurosurgery. 1999;44:748–53.

    Article  CAS  PubMed  Google Scholar 

  90. Mat Nayan SA, Mohd Haspani MS, Abd Latiff AZ, Abdullah JM, Abdullah S. Two surgical methods used in 90 patients with intracranial subdural empyema. J Clin Neurosci. 2009;16:1567–71.

    Article  CAS  PubMed  Google Scholar 

  91. Nathoo N, Nadvi SS, Dellen JR, Gouws E. Intracranial subdural empyemas in the era of computed tomography: a review of 699 cases. Neurosurgery. 1999;44:529–35.

    Article  CAS  PubMed  Google Scholar 

  92. Bockova J, Rigamonti D. Intracranial empyema. Pediatr Infect Dis J. 2000;19:735–7.

    Article  CAS  PubMed  Google Scholar 

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  1. Sheikh Khalifa Medical City, Critical Care Department, Abu Dhabi, United Arab Emirates

    Ahmed Reda Taha

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  1. Division of Critical Care, Karl Heusner Memorial Hospital, Belize City, Belize

    Jorge Hidalgo

  2. National School of Tropical Medicine, Baylor College of Medicine, Houston, TX, USA

    Laila Woc-Colburn

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Taha, A.R. (2020). Central Nervous System Infection. In: Hidalgo, J., Woc-Colburn, L. (eds) Highly Infectious Diseases in Critical Care. Springer, Cham. https://doi.org/10.1007/978-3-030-33803-9_9

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