Infections in Childhood

  • Vivek Yedavilli
  • Vivek Pandey
  • Delilah BurrowesEmail author


The CNS is relatively resistant to the neurotropic behavior of potential harmful pathogens. Our aim of this chapter is to review a few of the more common CNS pathogens that affect children through their development as a fetus through the newborn period and through childhood and review the imaging features, some nonspecific and specific, which may be seen.


Congenital infections Developing brain Neonate infection 


  1. 1.
    Singhi P, Griffin DE, Newton CR. Central nervous system infections in childhood. London: Mac Keith Press; 2014.Google Scholar
  2. 2.
    Ball WS. Pediatric neuroradiology. Philadelphia: Lippencott Raven; 1997.Google Scholar
  3. 3.
    Acosta JH, Rantes CI, Arbelaez A, et al. Noncongenital central nervous system infections in children: radiology review. Top Magn Reson Imaging. 2014;23(3):153–64.CrossRefGoogle Scholar
  4. 4.
    Chang LY, Huang LM, Gau SS, et al. Neurodevelopment and cognition in children after enterovirus 71 infection. N Engl J Med. 2007;356(12):1226–34.CrossRefGoogle Scholar
  5. 5.
    Idro R, Ndiritu M, Ogutu B, et al. Burden, features, and outcome of neurological involvement in acute falciparum malaria in Kenyan children. JAMA. 2007;297(20):2232–40.CrossRefGoogle Scholar
  6. 6.
    Modlin JF. Enterovirus deja vu. N Engl J Med. 2007;356(12):1204–5.CrossRefGoogle Scholar
  7. 7.
    Berkley JA, Mwangi I, Ngetsa CJ, et al. Diagnosis of acute bacterial meningitis in children at a district hospital in sub-Saharan Africa. Lancet. 2001;357(9270):1753–7.CrossRefGoogle Scholar
  8. 8.
    Hui A, Cheung KF, Lui C, et al. Herpes simplex encephalitis in Hong Kong: a retrospective review. Neurology Asia. 2005;10(Jun):35–8.Google Scholar
  9. 9.
    Singh S, Alexander M, Korah IP. Acute disseminated encephalomyelitis: MR imaging features. AJR Am J Roentgenol. 1999;173(4):1101–7.CrossRefGoogle Scholar
  10. 10.
    Baskin HJ, Hedlund G. Neuroimaging of herpesvirus infections in children. Pediatr Radiol. 2007;37(10):949–63.CrossRefGoogle Scholar
  11. 11.
    Solomon T. Flavivirus encephalitis. N Engl J Med. 2004;351(4):370–8.CrossRefGoogle Scholar
  12. 12.
    Handique SK, Barkataky N. MR imaging in biphasic Japanese encephalitis. AJNR Am J Neuroradiol. 2008;29(3):E3.CrossRefGoogle Scholar
  13. 13.
    Lo CP, Chen CY. Neuroimaging of viral infections in infants and young children. Neuroimaging Clin N Am. 2008;18(1):119–32. viii.CrossRefGoogle Scholar
  14. 14.
    Maloney JA, Mirsky DM, Messacar K, et al. MRI findings in children with acute flaccid paralysis and cranial nerve dysfunction occurring during the 2014 enterovirus D68 outbreak. AJNR Am J Neuroradiol. 2015;36(2):245–50.CrossRefGoogle Scholar
  15. 15.
    Awasthi M, Parmar H, Patankar T, et al. Imaging findings in rabies encephalitis. AJNR Am J Neuroradiol. 2001;22(4):677–80.PubMedGoogle Scholar
  16. 16.
    Burrill J, Williams CJ, Bain G, et al. Tuberculosis: a radiologic review. Radiographics. 2007;27(5):1255–73.CrossRefGoogle Scholar
  17. 17.
    Trivedi R, Saksena S, Gupta RK. Magnetic resonance imaging in central nervous system tuberculosis. Indian J Radiol Imaging. 2009;19(4):256–65.CrossRefGoogle Scholar
  18. 18.
    Gupta RK, Vatsal DK, Husain N, et al. Differentiation of tuberculous from pyogenic brain abscesses with in vivo proton MR spectroscopy and magnetization transfer MR imaging. AJNR Am J Neuroradiol. 2001;22(8):1503–9.PubMedGoogle Scholar
  19. 19.
    DeLone DR, Goldstein RA, Petermann G, et al. Disseminated aspergillosis involving the brain: distribution and imaging characteristics. AJNR Am J Neuroradiol. 1999;20(9):1597–604.PubMedPubMedCentralGoogle Scholar
  20. 20.
    Smith AB, Smirniotopoulos JG, Rushing EJ. From the archives of the AFIP: central nervous System infections associated with human immunodeficiency virus infection: radiologic-pathologic correlation. Radiographics. 2008;28(7):2033–58.CrossRefGoogle Scholar
  21. 21.
    Lin DJ, Sacks A, Shen J, et al. Neurocandidiasis: a case report and consideration of the causes of restricted diffusion. J Radiol Case Rep. 2013;7(5):1–5.PubMedPubMedCentralGoogle Scholar
  22. 22.
    Popovich MJ, Arthur RH, Helmer E. CT of intracranial cryptococcosis. AJR Am J Roentgenol. 1990;154(3):603–6.CrossRefGoogle Scholar
  23. 23.
    Donald KA, Walker KG, Kilborn T, et al. HIV Encephalopathy: pediatric case series description and insights from the clinic coalface. AIDS Res Ther. 2015;12(1):2.CrossRefGoogle Scholar
  24. 24.
    Bell JE, Brettle RP, Chiswick A, et al. HIV encephalitis, proviral load and dementia in drug users and homosexuals with AIDS. Effect of neocortical involvement. Brain. 1998;121(Pt 11):2043–52.CrossRefGoogle Scholar
  25. 25.
    Berger JR, Aksamit AJ, Clifford DB, et al. PML diagnostic criteria: consensus statement from the AAN neuroinfectious disease section. Neurology. 2013;80(15):1430–8.CrossRefGoogle Scholar
  26. 26.
    Murdoch DM, Venter WD, Feldman C, et al. Incidence and risk factors for the immune reconstitution inflammatory syndrome in HIV patients in South Africa: a prospective study. AIDS. 2008;22(5):601–10.CrossRefGoogle Scholar
  27. 27.
    Orikiiriza J, Bakeera-Kitaka S, Musiime V, et al. The clinical pattern, prevalence, and factors associated with immune reconstitution inflammatory syndrome in Ugandan children. AIDS. 2010;24(13):2009–17.CrossRefGoogle Scholar
  28. 28.
    Post MJ, Thurnher MM, Clifford DB, et al. CNS-immune reconstitution inflammatory syndrome in the setting of HIV infection, part 2: discussion of neuro-immune reconstitution inflammatory syndrome with and without other pathogens. AJNR Am J Neuroradiol. 2013;34(7):1308–18.CrossRefGoogle Scholar
  29. 29.
    Dollard SC, Grosse SD, Ross DS. New estimates of the prevalence of neurological and sensory sequelae and mortality associated with congenital cytomegalovirus infection. Rev Med Virol. 2007;17(5):355–63.CrossRefGoogle Scholar
  30. 30.
    Demmler GJ. Infectious Diseases Society of America and Centers for Disease Control. Summary of a workshop on surveillance for congenital cytomegalovirus disease. Rev Infect Dis. 1991;13(2):315–29.CrossRefGoogle Scholar
  31. 31.
    Kenneson A, Cannon MJ. Review and meta-analysis of the epidemiology of congenital cytomegalovirus (CMV) infection. Rev Med Virol. 2007;17(4):253–76.CrossRefGoogle Scholar
  32. 32.
    Griffiths PD, Walter S. Cytomegalovirus. Curr Opin Infect Dis. 2005;18(3):241–5.CrossRefGoogle Scholar
  33. 33.
    Fink KR, Thapa MM, Ishak GE, et al. Neuroimaging of pediatric central nervous system cytomegalovirus infection. Radiographics. 2010;30(7):1779–96.CrossRefGoogle Scholar
  34. 34.
    van der Knaap MS, Vermeulen G, Barkhof F, et al. Pattern of white matter abnormalities at MR imaging: use of polymerase chain reaction testing of Guthrie cards to link pattern with congenital cytomegalovirus infection. Radiology. 2004;230(2):529–36.CrossRefGoogle Scholar
  35. 35.
    de Vries LS, Gunardi H, Barth PG, et al. The spectrum of cranial ultrasound and magnetic resonance imaging abnormalities in congenital cytomegalovirus infection. Neuropediatrics. 2004;35(2):113–9.CrossRefGoogle Scholar
  36. 36.
    Noyola DE, Demmler GJ, Nelson CT, et al. Early predictors of neurodevelopmental outcome in symptomatic congenital cytomegalovirus infection. J Pediatr. 2001;138(3):325–31.CrossRefGoogle Scholar
  37. 37.
    Pomares C, Montoya JG. Laboratory diagnosis of congenital toxoplasmosis. J Clin Microbiol. 2016;54(10):2448–54.CrossRefGoogle Scholar
  38. 38.
    Carter AO, Frank JW. Congenital toxoplasmosis: epidemiologic features and control. CMAJ. 1986;135(6):618–23.PubMedPubMedCentralGoogle Scholar
  39. 39.
    Wilson CB, Remington JS, Stagno S, Reynolds DW. Development of adverse sequelae in children born with subclinical congenital Toxoplasma infection. Pediatrics. 1980;66(5):767–74.PubMedGoogle Scholar
  40. 40.
    Stamos JK, Rowley AH. Timely diagnosis of congenital infections. Pediatr Clin North Am. 1994;41(5):1017–33.CrossRefGoogle Scholar
  41. 41.
    Lynfield R, Guerina N. Toxoplasmosis. Pediatr Rev. 1997;18(3):75–83.CrossRefGoogle Scholar
  42. 42.
    Boppana SB, Pass RF, Britt WJ, et al. Symptomatic congenital cytomegalovirus infection: neonatal morbidity and mortality. Pediatr Infect Dis J. 1992;11(2):93–9.CrossRefGoogle Scholar
  43. 43.
    Holliman RE. Congenital toxoplasmosis: prevention, screening and treatment. J Hosp Infect. 1995;30(suppl):179–90.CrossRefGoogle Scholar
  44. 44.
    Malinger G, Werner H, Rodriguez Leonel JC, et al. Prenatal brain imaging in congenital toxoplasmosis. Prenat Diagn. 2011;31(9):881–6.PubMedGoogle Scholar
  45. 45.
    Becker LE. Infections of the developing brain. AJNR Am J Neuroradiol. 1992;13(2):537–49.PubMedGoogle Scholar
  46. 46.
    Rudnick C, Hoekzema G. Neonatal herpes simplex virus infections. Am Fam Physician. 2002;65(6):1138–42.PubMedGoogle Scholar
  47. 47.
    Caserta M, et al. Neonatal Herpes Simplex Virus (HSV) infection. Merck Manual Prof Version; 2015.Google Scholar
  48. 48.
    Caserta M, et al. Congenital syphilis. Merck Manual Prof Version; 2015.Google Scholar
  49. 49.
    Tyler KL. Update on herpes simplex encephalitis. Rev Neurol Dis. 2004;1(4):169–78.PubMedGoogle Scholar
  50. 50.
    Vossough A, Zimmerman RA, Bilaniuk LT, et al. Imaging findings of neonatal herpes simplex virus type 2 encephalitis. Neuroradiology. 2008;50(4):355–66.CrossRefGoogle Scholar
  51. 51.
    Hutto C, Arvin A, Jacobs R, et al. Intrauterine herpes simplex virus infections. J Pediatr. 1987;110(1):97–101.CrossRefGoogle Scholar
  52. 52.
    Leonard J, Moran C, Cross D, Wippold F, et al. MR imaging of herpes simplex type i encephalitis in infants and young children: a separate pattern of findings. AJR Am J Roentgenol. 2000;174(6):1651–5.CrossRefGoogle Scholar
  53. 53.
    Bajaj M, Mody S, Natarajan G. Clinical and neuroimaging findings in neonatal herpes simplex virus infection. J Pediatr. 2014;165(2):404–7.CrossRefGoogle Scholar
  54. 54.
    Barkovich AJ, Raybaud C, et al. Pediatric neuroimaging. 5th ed. Philadelphia: Lippincott Williams and Wilkens; 2012.Google Scholar
  55. 55.
    Shah G, et al. Central nervous system infections. Elsevier Health Sciences; 2012.Google Scholar
  56. 56.
    Blaser S, Jay V, Becker L, Ford-Jones EL. Neonatal brain infection. In: Ruthford M, editor. MRI of the neonatal brain. London: WB Saunders; 2002. Imaging; Part 4 Chapter 10.Google Scholar
  57. 57.
    de Fatima Vasco Aragao M, van der Linden V, Brainer-Lima AM, et al. Clinical features and neuroimaging (CT and MRI) findings in presumed Zika virus related congenital infection and microcephaly: retrospective case series study. BMJ. 2016;353:i1901.CrossRefGoogle Scholar

Copyright information

© Springer Nature Singapore Pte Ltd. 2019

Authors and Affiliations

  • Vivek Yedavilli
    • 1
  • Vivek Pandey
    • 1
  • Delilah Burrowes
    • 2
    Email author
  1. 1.Advocate Illinois Masonic Medical CenterChicagoUSA
  2. 2.Division of NeuroradiologyAnn & Robert H. Lurie Children’s Hospital of ChicagoChicagoUSA

Personalised recommendations