Central Nervous System Infections

Archibald, Lennox K.; Quisling, Ronald G.

doi:10.1007/978-1-4471-5226-2_22

Cited by 26 publications

(33 citation statements)

References 466 publications

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“…Together with the choroid plexus, the blood‐brain barrier protects the brain from invading microorganisms 162 . Nevertheless, several pathogens, including viruses, are still able to traverse the barriers, 163 especially in cases of systemic inflammation 164 causing potential alterations of the central nervous system (CNS). In particular, coronaviruses might exhibit neurotropic properties, 165 and SARS‐CoV was detected in human brain 166,167 .…”

Section: Development and Failure Of An Adequate Immune Responsementioning

confidence: 99%

Immunology of COVID‐19: Mechanisms, clinical outcome, diagnostics, and perspectives—A report of the European Academy of Allergy and Clinical Immunology (EAACI)

Sokołowska

Łukasik

Agache

et al. 2020

Allergy

143

156

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With the worldwide spread of the novel severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) resulting in declaration of a pandemic by the World Health Organization (WHO) on March 11, 2020, the SARS-CoV-2-induced coronavirus disease-19 (COVID-19) has become one of the main challenges of our times. The high infection rate and the severe disease course led to major safety and social restriction measures worldwide. There is an urgent need of unbiased expert knowledge guiding the development of efficient treatment and prevention strategies. This report summarizes current immunological data on mechanisms associated with the SARS-CoV-2 infection and COVID-19 development and progression to the most severe forms. We characterize the differences between adequate innate and adaptive immune response in mild disease and the deep immune dysfunction in the severe multiorgan disease. The similarities of the human immune response to SARS-CoV-2 and the SARS-CoV and MERS-CoV are underlined. We also summarize known and potential SARS-CoV-2 receptors on epithelial barriers, immune cells, endothelium and clinically involved organs such as lung, gut, kidney, cardiovascular, and neuronal system. Finally, we discuss the known and potential mechanisms underlying the involvement of comorbidities, gender, and age in development of COVID-19. Consequently, we highlight the knowledge gaps and urgent research requirements to provide a quick roadmap for ongoing and needed COVID-19 studies.

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Section: Development and Failure Of An Adequate Immune Responsementioning

confidence: 99%

Immunology of COVID‐19: Mechanisms, clinical outcome, diagnostics, and perspectives—A report of the European Academy of Allergy and Clinical Immunology (EAACI)

Sokołowska

Łukasik

Agache

et al. 2020

Allergy

143

156

View full text Add to dashboard Cite

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“…CNS infection broadly can be categorized as encephalitis, meningitis, or intracranial suppurative complications (e.g., brain abscess), with a broad range of causal organisms and clinical presentations. CNS infections can either originate by hematogenous spread (e.g., bacteremia, viremia), by retrograde neuronal invasion (e.g., viral infection through axonal transport such as rabies, Naegleria fowleri) or by contiguous spread of microorganisms (e.g., post cranial trauma or surgery, implementation of medical hardware into the brain or spine, or by parameningeal spread from a focus such as sinusitis or mastoiditis) (Archibald and Quisling, 2013;Koyuncu et al, 2013). Various bacteria, fungi, viruses, and parasites can be the source of CNS infection, which often presents nonspecifically with headache, fever, altered mental status, and behavioral changes (Dorsett and Liang, 2016).…”

Section: Introductionmentioning

confidence: 99%

The Use of Adjunctive Steroids in Central Nervous Infections

Gundamraj

Hasbun

2020

Front. Cell. Infect. Microbiol.

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Central nervous system (CNS) infections continue to be associated with significant neurological morbidity and mortality despite various existing therapies. Adjunctive steroid therapy has been employed clinically to reduce inflammation in the treatment of CNS infections across various causative pathogens. Steroid therapy can potentially improve clinical outcomes including reducing mortality rates, provide no significant benefit, or cause worsened outcomes, based on the causative agent of infection. The data on benefits or harms of adjunctive steroid therapy is not consistent in outcome or density through CNS infections, and varies based on the disease diagnosis and pathogen. We summarize the existing literature on the effects of adjunctive steroid therapy on outcome for a number of CNS infections, including bacterial meningitis, herpes simplex virus, West Nile virus, tuberculosis meningitis, cryptococcal meningitis, Angiostrongylus cantonensis, neurocysticercosis, autoimmune encephalitis, toxoplasmosis, and bacterial brain abscess. We describe that while steroid therapy is beneficial and supported in pathogens such as pneumococcal meningitis and tuberculosis, for other diseases, like Listeria monocytogenes and Cryptococcus neoformans they are associated with worse outcomes. We highlight areas of consistent and proven findings and those which need more evidence for supported beneficial clinical use of adjunctive steroid therapy.

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“…The widespread process of parenchymal inflammation may cause brain edema that may also increase the intracranial pressure. 16,17 This condition may result in decrease of consciousness and death. 18 The aforementioned pathophysiological process will result in global cerebral dysfunction and encephalopathy.…”

Section: Discussionmentioning

confidence: 99%

Abnormal electroencephalographyas predictor of mortality in meningoencephalitis

2020

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Although the incidence of meningoencephalitis has decreased,howeverits mortality remainshigh. Electroencephalography (EEG) has an important role in the management of meningoencephalitis although the imaging modalities have replaced its position. Abnormality in EEG may appear earlier than in imaging so it is expected to predict mortality.The study aimed to investigate the prognostic role of EEG results in predicting mortality of meningoencephalitis.This was an observational prospective cohort study involvingmeningoencephalitis patients in Dr. Sardjito General Hospital,Yogyakartafrom July 2016 to January 2017 who underwent EEG examination.The patients who met the inclusion and exclusion criteria were divided into abnormal and normal EEG groups. The outcomewas the mortality during hospitalization. Furthermore, the type of EEG abnormalities associated with mortality were evaluated.Thirty-eight patients with the mean age was 33.61±20.37 yearwere involved in this study. Twenty-eight patients (73.7%) had abnormal EEG result and 10 patients (26.3%) death.Bivariate analysis showed that abnormal EEG result (p =0.028) and Glasgow Coma Scale (GCS) score (p =0.005) were significantly associated with mortality. Analysis for the type of EEG abnormalities found that only diffuse slowing (p =0.001) was significantly associated with mortality. Multivariate analysis showed either abnormal EEG result or GCS score were independently predictor of mortality. Abnormal EEG and GCS score were interrelated in affecting mortality.In conclusion, abnormal EEG resultin meningoencephalitis, diffuse slowing in particular, is predictor of mortality during hospitalization ABSTRAK Meskipuninsidensi meningoensefalitis menurun, namun mortalitas tetap tinggi. Elektroensefalografi (EEG) berperan penting dalam tatalaksana meningoensefalitis, meskipun modalitaspencitraan telah mengganti perannya. Abnormalitas pada EEGnampak lebih awal dibandingkan pencitraan sehingga diharapkan dapat memprediksi mortalitas.Penelitian ini bertujuan untuk mengkaji peran prognostik dari hasil pemeriksaan EEG dalam memprediksi mortalitas meningoensefalitis. Penelitian ini merupakan studi kohort prospektif observasional melibatkanpasien meningoensefalitis di RSUP Dr. Sardjito, Yogyakartadari bulan Juli 2016 sampai Januari 2017 yang menjalani pemeriksaan EEG.Pasien dibagi menjadi kelompok EEG abnormal dan normal. Luaran adalah kematian selama dirawat di rumah sakit.Tipe abnormalitas EEG terkait kematian dievaluasi.Sebanyak 38 pasien rata-rata berusia 33,61±20,37 tahun terlibat dalam penelitian.Sebanyak 28 pasien (73,7%) mempunyai hasil EEG abnormal dan pasien meninggal 10 (26,3%) orang. Analisis bivariat menunjukkan bahwa hasil EEG abnormal (p =0,028) dan skor Glasgow Coma Scale (GCS) berhubungan bermakna dengan kematian(p =0,005). Analisis terhadap tipe abnormalitas EEGmenunjukkan hanya perlambatan difus yang berhubungan bermakna dengan kematian(p =0,001). Analisis multivariat menunjukkan baik hasil EEG abnormal maupun skor GCS secara independen merupakan prediktorkematian. E...

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Central Nervous System Infections

Cited by 26 publications

References 466 publications

Immunology of COVID‐19: Mechanisms, clinical outcome, diagnostics, and perspectives—A report of the European Academy of Allergy and Clinical Immunology (EAACI)

Immunology of COVID‐19: Mechanisms, clinical outcome, diagnostics, and perspectives—A report of the European Academy of Allergy and Clinical Immunology (EAACI)

The Use of Adjunctive Steroids in Central Nervous Infections

Abnormal electroencephalographyas predictor of mortality in meningoencephalitis

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