Approach to the Patient with CNS Infection

Definition

  • Acute central nervous system (CNS) infections include the following distinct clinical syndromes:
    • Acute bacterial meningitis
    • Nonbacterial meningitis (viral, fungal, mycobacterial, parasitic)
    • Encephalitis
    • Focal infections such as:
      • Brain abscess
      • Subdural empyema
      • Infectious venous thrombosis
  • A CNS infection may predominantly involve:
    • Subarachnoid space (meningitis)
    • Brain tissue in the cerebral hemispheres, cerebellum, or brainstem (encephalitis, generalized or localized)
    • Both the subarachnoid space and brain tissue (meningoencephalitis)
  • Focal bacterial, fungal, or parasitic infections involving brain tissue are classified as abscess (capsule present) or cerebritis (capsule absent).

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