Bacterial Infections of the Central Nervous System

Abstract

Bacterial infections of the central nervous system are a neurological emergency. Prompt recognition and treatment are not only essential to prevent mortality but also to decrease neurological sequelae. This chapter will focus on the two most common central nervous system bacterial infections, bacterial meningitis and spinal epidural abscess. The eradication of the pathogen with antimicrobial therapy is the easy part. It is the recognition of the disorder, the understanding of the diagnostic studies and their limitations, and the management of the neurological complications that requires the expertise of a neurologist.

The role of postictal laboratory blood analyses in the diagnosis and prognosis of seizures

“…Common febrile illnesses, such as upper respiratory or urinary tract infections, may lower the seizure threshold in patients with epilepsy and be accompanied by typical laboratory changes such as leukocytosis and CRP. A thorough review is beyond the scope of this article, but recent reviews exist [136][137][138][139][140][141][142][143][144][145][146].…”

Headache: When to Worry

“…CSF analysis helps in identification of the underlying etiology as bacterial meningitis usually presents with very high WBCs and elevated CSF opening pressure (Table 4) [31]. Streptococcus pneumoniae, Neisseria meningitidis, Listeria monocytogenes, group B streptococci, and Haemophilus influenza are the most prevalent bacteria that cause meningitis in the community; of which Streptococcus pneumonia is the most common among all age groups except infants less than 2 months [32]. Enteroviruses, herpes viruses, arbo viruses, and HIV usually cause viral meningitis.…”

“…Empirical antibiotic therapy depends on the age and any associated comorbidities, most of the recommended regimens include a third or fourth generation cephalosporins along with vancomycin [32]. When there is a suspicion for Listeria monocytogenes especially in immunocompromised host, ampicillin should also be added to this regimen [34].…”

“…Dexamethasone (10 mg every 6 h for 2-4 days) should be initiated prior to or with the first antibiotic dose. It should be discontinued if the etiology is non-bacterial [32].…”

Desenvolvimento de genossensor eletroquímico para diagnóstico de meningite pneumocócica

“…A severidade da MB depende do tipo de bactéria causadora. Em adultos, a MB provoca danos neuronais no córtex cerebral, hipocampo e ouvido interno e estão associadas a perda de audição, déficit motor, problemas cognitivos e com a fala, enquanto que a surdez neurossensorial, seguida de distúrbio convulsivo e déficit motor são mais comuns em crianças (ROOS, 2010).…”