Current Treatment Options in Neurology

, Volume 8, Issue 2, pp 135–144

Central nervous system infections in the neurointensive care unit

  • Fred Rincon
  • Neeraj Badjatia

Opinion statement

Central nervous system (CNS) infections are frequently encountered at the primary care level, in emergency rooms, medical wards, and intensive care units. Advances in immunization techniques and aggressive prevention campaigns have had an impact on the worldwide incidence of community-acquired meningitis, limiting this disease to the adult population. In general, a high index of suspicion is required for the diagnosis, but special attention should be given to the immunocompromised host and post-neurosurgical patient in whom the clinical presentation may be nonspecific. Once the diagnosis is made, broadspectrum antimicrobials should be administered, followed by diagnostic testing, and targeted antibiotic therapy. Current guidelines for the treatment of meningitis are clinically effective but are not based on randomized, prospective, controlled trials. Despite current therapies, the morbidity of CNS infections is still devastating. Recent trials of the use of corticosteroids as coadjuvants of antibiotic therapy showed promising results and decrease in the morbidity associated with bacterial and tuberculous meningitis. Additional neuroprotective alternatives should be the focus of future research. Similarly, guidelines for the diagnosis and management of post-neurosurgical procedure meningitis and ventriculostomy-related infections are needed.


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Copyright information

© by Current Science Inc 2006

Authors and Affiliations

  • Fred Rincon
  • Neeraj Badjatia
    • 1
  1. 1.Division of Stroke and Critical Care Department of NeurologyColumbia University College of Physicians and Surgeons; Neurological InstituteNew YorkUSA

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