Central nervous system infections

Abstract

Bacterial meningitis continues to be an important neurological disease worldwide. It is associated with high mortality and frequent neurological sequelae and requires expeditious management. Empiric therapeutic regimens for bacterial meningitis depend on the patient's age. This chapter focuses on treatment of older children and adults. Adjunctive corticosteroid may attenuate the inflammatory response in mycobacterial meningitis and thus lead to improve outcome. Fungal infections of the CNS occur primarily in immunocompromised individuals and have gained importance with the increased number of patients with immune deficits. The most important medication in the treatment of Herpes simplex virus 1 (HSV-1) encephalitis to date is acyclovir, a purine nucleoside analogue. Cryptococcus neoformans is the most common cause of meningitis in patients with HIV infection and is frequently seen in transplant patients. Treatment of cryptococcal meningitis consists of three phases: an induction, a consolidation and a maintenance phase.