Epidemiology, diagnosis, and assessment of meningitis and encephalitis

Abstract

Despite advances in antimicrobial therapy, central nervous system infections have a high morbidity and mortality. Most pathogens reach the brain by haematogenous spread following invasion through the mucosal surface of the nasopharynx. The cerebrospinal fluid inflammatory response is responsible for most of the deleterious effects of the infection. Understanding this response has allowed a more rational approach to therapy. Patients may present with non-specific features, especially neonates, infants, post-neurosurgical patients, and the elderly. This chapter will review the epidemiology, pathophysiology, clinical presentation, and diagnosis of acute bacterial meningitis and encephalitis.