CNS infections and their treatment

Central nervous system (CNS) infections are medical conditions caused by various pathogens, such as bacteria, viruses, fungi, or parasites, that affect the brain, spinal cord, or other tissues within the CNS. Below are some common CNS infections, their causes, treatment options, and references for further information.

Bacterial meningitis [1]:

Cause: Bacteria such as Streptococcus pneumoniae, Neisseria meningitidis, Haemophilus influenzae, or Listeria monocytogenes.
Treatment: Antibiotics (e.g., ceftriaxone, vancomycin, ampicillin), corticosteroids (e.g., dexamethasone), and supportive care.

Viral meningitis [2]:

Cause: Viruses such as enteroviruses, herpes simplex virus, or arboviruses.
Treatment: Supportive care, antiviral medications (e.g., acyclovir for herpes simplex virus meningitis).

Encephalitis [3]:

Cause: Viruses such as herpes simplex virus, varicella-zoster virus, enteroviruses, or arboviruses.
Treatment: Antiviral medications (e.g., acyclovir for herpes simplex encephalitis), corticosteroids, immunoglobulin, and supportive care.

Brain abscess [4]:

Cause: Bacteria, fungi, or parasites.
Treatment: Surgical drainage, antibiotics, antifungal or antiparasitic medications (depending on the causative agent), and supportive care.

Fungal meningitis [5]:

Cause: Fungi such as Cryptococcus neoformans, Candida species, or Aspergillus species.
Treatment: Antifungal medications (e.g., amphotericin B, flucytosine, fluconazole), and supportive care.

Tuberculous meningitis [6]:

Cause: Mycobacterium tuberculosis.
Treatment: Antituberculosis medications (e.g., isoniazid, rifampin, pyrazinamide, ethambutol), corticosteroids, and supportive care.

Neurosyphilis [7]:

Cause: Treponema pallidum (syphilis bacterium)
Treatment: Penicillin, other antibiotics (e.g., ceftriaxone, doxycycline, or azithromycin) in case of penicillin allergy, and supportive care.

Neurocysticercosis [8]:

Cause: Taenia solium (pork tapeworm)
Treatment: Antiparasitic medications (e.g., albendazole), corticosteroids, antiepileptic medications, and supportive care.

Progressive multifocal leukoencephalopathy (PML) [9]:

Cause: JC virus reactivation, typically in immunocompromised individuals
Treatment: Reversing immunosuppression, supportive care, and experimental treatments such as antiviral medications (e.g., cidofovir) or immune-based therapies.

References:

1. van de Beek, D., Cabellos, C., Dzupova, O., Esposito, S., Klein, M., Kloek, A. T., … & Scheld, W. M. (2016). ESCMID guideline: diagnosis and treatment of acute bacterial meningitis. Clinical Microbiology and Infection, 22, S37-S62.
2. Logan, S. A., & MacMahon, E. (2008). Viral meningitis. BMJ, 336(7634), 36-40.
3. Solomon, T., Michael, B. D., Smith, P. E., Sanderson, F., Davies, N. W. S., Hart, I. J., … & Kneen, R. (2012). Management of suspected viral encephalitis in adults—Association of British Neurologists and British Infection Association National Guidelines. Journal of Infection, 64(4), 347-373.
4. Brouwer, M. C., Coutinho, J. M., & van de Beek, D. (2014). Clinical characteristics and outcome of brain abscess: Systematic review and meta-analysis. Neurology, 82(9), 806-813.
5. Perfect, J. R., Dismukes, W. E., Dromer, F., Goldman, D. L., Graybill, J. R., Hamill, R. J., … & Sobel, J. D. (2010). Clinical practice guidelines for the management of cryptococcal disease: 2010 update by the Infectious Diseases Society of America. Clinical Infectious Diseases, 50(3), 291-322.
6. Thwaites, G., Fisher, M., Hemingway, C., Scott, G., Solomon, T., & Innes, J. (2009). British Infection Society guidelines for the diagnosis and treatment of tuberculosis of the central nervous system in adults and children. Journal of Infection, 59(3), 167-187.
7. Marra, C. M., Maxwell, C. L., & Tantalo, L. C. (2012). The diagnosis and management of neurosyphilis. Current Neurology and Neuroscience Reports, 12(5), 488-495.
8. Garcia, H. H., Nash, T. E., & Del Brutto, O. H. (2014). Clinical symptoms, diagnosis, and treatment of neurocysticercosis. The Lancet Neurology, 13(12), 1202-1215.
9. Berger, J. R., & Aksamit, A. J. (2018). Progressive multifocal leukoencephalopathy. CONTINUUM: Lifelong Learning in Neurology, 24(5), 1364-1381.

Disclaimer: This article is for informational purposes only and should not be taken as medical advice. Always consult with a healthcare professional before making any decisions related to medication or treatment.