• Swagata Tripathy


Sepsis results from microbial invasion of sterile areas of the body. The manifestations can be diverse leading to diagnostic dilemmas. More than one-third of neurosurgical patients in the neurointensive care units (ICU) are diagnosed with sepsis; the common infections are pneumonia, urinary tract, blood stream, and intracranial infections. A dysregulated immune response involving the hypothalamo-pituitary axis and the sympathetic nervous system follows trauma to the brain tissue. This phenomenon referred to as “brain injury induced immunosuppression syndrome” results in increased susceptibility to infections. Among measures to prevent infection, noninvasive ventilation and early separation from the ventilator along with screening for swallowing difficulties have proven to be of benefit: prophylactic antibiotics and oral decontamination have not. Treatment of sepsis in patients in the neuro-ICU follows the similar principles as in all septic patients, with emphasis on early recognition and quick intervention, fluid resuscitation, and antibiotics tailored to the organism causing the infection.


Dysregulated immune response Sepsis Septic shock Intracranial infection EVD-related infection Healthcare-associated ventriculitis and meningitis Early treatment 


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Copyright information

© Springer Nature Singapore Pte Ltd. 2019

Authors and Affiliations

  • Swagata Tripathy
    • 1
  1. 1.Department of Anesthesia and Intensive CareAll India Institute of Medical SciencesBhubaneswarIndia

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