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Chapter 24 : Central Nervous System Infections

Authors: Andrea J. Zimmer1, Victoria E. Burke2, Karen C. Bloch3
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Affiliations: 1: University of Nebraska Medical Center, Omaha, NE 68198; 2: Louisiana State University Health Sciences Centre, New Orleans, LA 70119; 3: Vanderbilt University Medical Center Departments of Medicine and Health Policy, Nashville, TN 37232
Content Type: Monograph
Publication Year: 2016

Category: Clinical Microbiology

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Abstract:

Infections of the central nervous system (CNS) are associated with significant morbidity and mortality, with outcome often dependent on the rapidity with which a pathogen is identified and appropriate therapy is begun. Immunocompromised hosts are at risk for CNS infections with both common microorganisms, which may present atypically in this population, and with opportunistic pathogens. The microbiologic causes of infection vary by syndrome (e.g., meningitis versus encephalitis) and specific impairment in immunity (e.g., deficits in T-cell function versus hypogammaglobulinemia). This chapter provides a framework for the assessment and laboratory evaluation of immunocompromised patients presenting with CNS infections. Detailed discussions of the individual agents are provided in the corresponding pathogen-specific chapters.

Citation: Zimmer A, Burke V, Bloch K. 2016. Central Nervous System Infections, p 629-651. In Hayden R, Wolk D, Carroll K, Tang Y (ed),

Diagnostic Microbiology of the Immunocompromised Host, Second Edition

. ASM Press, Washington, DC. doi: 10.1128/microbiolspec.DMIH2-0012-2015
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Central Nervous System Infections
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Citation: Zimmer A, Burke V, Bloch K. 2016. Central Nervous System Infections, p 629-651. In Hayden R, Wolk D, Carroll K, Tang Y (ed),

Diagnostic Microbiology of the Immunocompromised Host, Second Edition

. ASM Press, Washington, DC. doi: 10.1128/microbiolspec.DMIH2-0012-2015
/content/10.1128/9781555819040.chap24.fig24-1
Figure 1

meningoencephalitis in a patient with acquired immunodeficiency syndrome. Case published as reference .

10.1128/9781555819040/fig24-1_thmb.gif
10.1128/9781555819040/fig24-1.gif
Image of Figure 1
Figure 1

meningoencephalitis in a patient with acquired immunodeficiency syndrome. Case published as reference .

Citation: Zimmer A, Burke V, Bloch K. 2016. Central Nervous System Infections, p 629-651. In Hayden R, Wolk D, Carroll K, Tang Y (ed),

Diagnostic Microbiology of the Immunocompromised Host, Second Edition

. ASM Press, Washington, DC. doi: 10.1128/microbiolspec.DMIH2-0012-2015
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Figure 2

trypomastigote in CSF stained with Giemsa. Image courtesy of CDC Division of Parasitic Diseases and Malaria, DPDx. http://www.cdc.gov/dpdx/trypanosomiasisAmerican/gallery.html#tcruzicsf trypomastigote in cerebrospinal fluid (CSF) stained with Giemsa. Image courtesy of CDC Division of Parasitic Diseases and Malaria, DPDx. http://www.cdc.gov/dpdx/trypanosomiasisAmerican/gallery.html#tcruzi

10.1128/9781555819040/fig24-2_thmb.gif
10.1128/9781555819040/fig24-2.gif
Image of Figure 2
Figure 2

trypomastigote in CSF stained with Giemsa. Image courtesy of CDC Division of Parasitic Diseases and Malaria, DPDx. http://www.cdc.gov/dpdx/trypanosomiasisAmerican/gallery.html#tcruzicsf trypomastigote in cerebrospinal fluid (CSF) stained with Giemsa. Image courtesy of CDC Division of Parasitic Diseases and Malaria, DPDx. http://www.cdc.gov/dpdx/trypanosomiasisAmerican/gallery.html#tcruzi

Citation: Zimmer A, Burke V, Bloch K. 2016. Central Nervous System Infections, p 629-651. In Hayden R, Wolk D, Carroll K, Tang Y (ed),

Diagnostic Microbiology of the Immunocompromised Host, Second Edition

. ASM Press, Washington, DC. doi: 10.1128/microbiolspec.DMIH2-0012-2015
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Tables

Central Nervous System Infections
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Citation: Zimmer A, Burke V, Bloch K. 2016. Central Nervous System Infections, p 629-651. In Hayden R, Wolk D, Carroll K, Tang Y (ed),

Diagnostic Microbiology of the Immunocompromised Host, Second Edition

. ASM Press, Washington, DC. doi: 10.1128/microbiolspec.DMIH2-0012-2015
/content/10.1128/9781555819040.chap24.tab24-1
Table 1

Major infectious causes of meningitis among immunocompromised hosts

Generic image for table
Table 1

Major infectious causes of meningitis among immunocompromised hosts

Citation: Zimmer A, Burke V, Bloch K. 2016. Central Nervous System Infections, p 629-651. In Hayden R, Wolk D, Carroll K, Tang Y (ed),

Diagnostic Microbiology of the Immunocompromised Host, Second Edition

. ASM Press, Washington, DC. doi: 10.1128/microbiolspec.DMIH2-0012-2015
/content/10.1128/9781555819040.chap24.tab24-2
Table 2

Major infectious causes of encephalitis or mass lesions of the brain among immunocompromised hosts

Generic image for table
Table 2

Major infectious causes of encephalitis or mass lesions of the brain among immunocompromised hosts

Citation: Zimmer A, Burke V, Bloch K. 2016. Central Nervous System Infections, p 629-651. In Hayden R, Wolk D, Carroll K, Tang Y (ed),

Diagnostic Microbiology of the Immunocompromised Host, Second Edition

. ASM Press, Washington, DC. doi: 10.1128/microbiolspec.DMIH2-0012-2015
/content/10.1128/9781555819040.chap24.tab24-3
Table 3

Infectious causes of myelitis among immunocompromised patients

Generic image for table
Table 3

Infectious causes of myelitis among immunocompromised patients

Citation: Zimmer A, Burke V, Bloch K. 2016. Central Nervous System Infections, p 629-651. In Hayden R, Wolk D, Carroll K, Tang Y (ed),

Diagnostic Microbiology of the Immunocompromised Host, Second Edition

. ASM Press, Washington, DC. doi: 10.1128/microbiolspec.DMIH2-0012-2015
/content/10.1128/9781555819040.chap24.tab24-4
Table 4

Microbiological methods used for laboratory diagnosis of CNS infections

Generic image for table
Table 4

Microbiological methods used for laboratory diagnosis of CNS infections

Citation: Zimmer A, Burke V, Bloch K. 2016. Central Nervous System Infections, p 629-651. In Hayden R, Wolk D, Carroll K, Tang Y (ed),

Diagnostic Microbiology of the Immunocompromised Host, Second Edition

. ASM Press, Washington, DC. doi: 10.1128/microbiolspec.DMIH2-0012-2015

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