Principles of Management of Central Nervous System Infections

Review Article
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Abstract

CNS infections in children are medical emergency and are associated with high mortality and morbidity. For diagnosis, a high index of suspicion is required. Clinical assessment should be supplemented by laboratory investigations including CSF Gram stain and cultures, blood culture, PCR on CSF, serological tests, and imaging. Commonly associated life threatening complications include coma, seizure, raised intracranial pressure (ICP), focal deficits, shock, respiratory failure, and fluid and electrolyte abnormalities. Immediate management should first address control of airway, breathing and circulation; protocolized management of raised ICP and status epilepticus; maintaining adequate intravascular volume; and close monitoring for early detection of complications. Appropriate antimicrobial agents should be administered promptly according to the suspected pathogen. Clinical evaluation, laboratory workup, specific antimicrobial therapy, supportive treatment, and management of associated complications should go hand in hand in a protocolized way for better outcome.

Keywords

Meningitis Encephalitis Raised ICP Status epilepticus Antibiotics Steroids 

Notes

Contributions

Both the authors have contributed to the manuscript in significant ways, have reviewed and agreed upon the manuscript content. SS will act as guarantor for this paper.

Compliance with Ethical Standards

Conflict of Interest

None.

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Copyright information

© Dr. K C Chaudhuri Foundation 2018

Authors and Affiliations

  1. 1.Division of PediatricsMedanta- The MedicityHaryanaIndia
  2. 2.Department of PediatricsGovernment Medical College and HospitalChandigarhIndia

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