Bacterial Infections of the Central Nervous System

LaPenna, Paul A.; Roos, Karen L.

doi:10.1055/s-0039-1693159

Cited by 28 publications

(25 citation statements)

References 34 publications

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“…(2) Examination of CSF released by lumbar puncture: cloudy, intracranial pressure > 200 mmH 2 O, white blood cell count > 50 × 10 6 /L, glucose < 2.2 mmol/L or a CSF glucose/serum glucose ratio < 0.4, CSF protein > 0.45 g/L [ 9 ]…”

Section: Methodsmentioning

confidence: 99%

Analysis of risk factors and preventive strategies for intracranial infection after neuroendoscopic transnasal pituitary adenoma resection

Huang

Zhang²,

Zhou

et al. 2022

BMC Neurosci

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Objective To analyse the risk factors for intracranial infection after neuroendoscopic transnasal pituitary adenoma resection (NTPAR) to provide a reference for the prevention and treatment of postoperative intracranial infection. Methods The clinical data of 387 patients who underwent NTPAR in the Department of Neurosurgery of the First People’s Hospital of Yichang from March 2013 to March 2021 were retrospectively analysed. The patients were divided into an infected group and a noninfected group according to the occurrence of intracranial infection. The detailed clinical data of the two groups were collected. Univariate and multivariate logistic regression was used to analyse the risk factors for intracranial infection after NTPAR. Results Among the 387 surgical patients, 32 patients (8.27%) were in the intracranially infected group and 355 patients (91.73%) were in the noninfected group. The results of the univariate analysis suggested that age > 45 years, tumour size > 1 cm, operation time > 240 min, blood loss > 400 ml, Kelly Grade of cerebrospinal fluid (CSF) leakage > Grade 2, postoperative CSF leakage, lumbar cistern drainage and blood transfusion were the influencing factors for postoperative intracranial infection, while the results of multivariate logistic regression analysis implied that intraoperative CSF leakage (Kelly Grade > 2) and postoperative CSF leakage were independent influencing factors for intracranial infection after NTPAR, and perioperative use of antibiotics was an independent protective factor for postoperative intracranial infection. Conclusions There are a variety of risk factors for intracranial infection after NTPAR, which indicates that it is necessary to develop different repair strategies for CSF leakage according to the Kelly Grade, timely treatment of postoperative CSF leakage and perioperative use of antibiotics. These measures have been shown to effectively reduce the probability of intracranial infection after NTPAR.

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Section: Methodsmentioning

confidence: 99%

Analysis of risk factors and preventive strategies for intracranial infection after neuroendoscopic transnasal pituitary adenoma resection

Huang

Zhang²,

Zhou

et al. 2022

BMC Neurosci

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“…Bacterial infections of the CNS lead to severe and permanent neurological deficits and life-threatening conditions ( LaPenna & Roos, 2019 ). Evidence indicates that in addition to microglia, astrocytes contribute to bacterial infections of the CNS, by recognizing bacteria-derived molecules such as LPS and bacterial DNA ( Geyer et al, 2019 ).…”

Section: Role Of Astroglial Tlrs In Bacterial Infections Of the Cnsmentioning

confidence: 99%

Role of astroglial toll-like receptors (TLRs) in central nervous system infections, injury and neurodegenerative diseases

Acıoğlu

Heary

et al. 2021

Brain, Behavior, and Immunity

190

129

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Highlights Astroglial TLRs mediate host-defense and pathogen dissemination in CNS infections. Astroglial TLRs help clearance of protein aggregates in neurodegenerative diseases. Astroglial TLR signaling contributes to inflammation in CNS injury and disease. Signaling through TLRs promotes beneficial and detrimental functions of astrocytes. TLRs in astrocytes could be therapeutic targets in CNS disease and injury.

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“…Mid-thoracic and lower thoracic spinal infectious processes, for example, can present as lower back pain [ 11 ]. In addition, patients with SEA may present with fever and neurologic deficits, and symptoms can also vary depending on the SEA location (for instance, cases with cervical involvement may present with dysphagia, while cases with thoracic involvement can potentially manifest with autonomic dysregulation [ 2 , 11 , 13 ]. Presenting with both back and radicular pain is more frequently seen with the acute form, and much less so for the chronic form [ 1 ].…”

Section: Discussionmentioning

confidence: 99%

Disseminated Spinal Epidural Abscess in an Immunocompetent Individual: A Case Report and Review of the Literature

et al. 2020

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Spinal epidural abscess (SEA) is an uncommon pyogenic infection, localized between the dura mater and vertebral periosteum, leading to significant morbidity and mortality. SEA development is connected with medical comorbidities and risk factors facilitating bacterial dissemination; multiple factors are believed to play a role, including aging, increased alcohol abuse, use of intravenous drugs, a greater prevalence of medical comorbidities, and increased rates of spinal surgery that furthers iatrogenic spinal infection. Here, we have reported the first known case of disseminated SEA in an immunocompetent individual. A 33-year-old Japanese woman visited our hospital due to 1 week of continuous fever, low back pain, and numbness of the entire left lower limb. She was diagnosed with disseminated SEA by complete spine magnetic resonance imaging scan, of unknown origin. She was treated for 13 days with piperacillin-tazobactam, then for 16 days with levofloxacin tablets; ultimately, she recovered without treatment complications. This case highlights the complicated pathology, diagnosis, and treatment of SEA. In addition, this case suggests the need for a careful and detailed examination when encountering patients presenting with fever, low back pain even in an immunocompetent individual; we should thoroughly investigate, including further image investigations, bacteriological and pathologic examination.

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Bacterial Infections of the Central Nervous System

Cited by 28 publications

References 34 publications

Analysis of risk factors and preventive strategies for intracranial infection after neuroendoscopic transnasal pituitary adenoma resection

Analysis of risk factors and preventive strategies for intracranial infection after neuroendoscopic transnasal pituitary adenoma resection

Role of astroglial toll-like receptors (TLRs) in central nervous system infections, injury and neurodegenerative diseases

Disseminated Spinal Epidural Abscess in an Immunocompetent Individual: A Case Report and Review of the Literature

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