Common infectious diseases of the central nervous system—clinical features and imaging characteristics

Li, Shan; Nguyen, Ivy; Urbanczyk, Kyle

doi:10.21037/qims-20-886

Cited by 20 publications

(14 citation statements)

References 72 publications

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“…Patients who had seizures or head imaging suggesting parenchymal involvement were presumed to have meningoencephalitis. All other patients were deemed to have meningitis [15].…”

Section: Methodsmentioning

confidence: 99%

Viral aetiology of acute central nervous system infections in children, Iran

Khalili

Rahimi

Akbari

et al. 2022

Journal of Medical Microbiology

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Introduction. Viral infections are increasingly an important cause of central nervous system (CNS) complications. Hypothesis/Gap Statement. There is no comprehensive insight about CNS infections due to viral agents among Iranian children. Aim. This study aimed to investigate the viral aetiology, clinical and epidemiological profile of children with acute infections of the CNS. Methodology. A prospective study was conducted on children at the referral hospital in Isfahan, Iran, from June 2019 to June 2020. A multiplex PCR assay was used to detect the viral causative agent in cerebrospinal fluid and throat/rectal swab samples. Results. Among 103 patients with eligible criteria, a confirmed or probable viral aetiology was detected in 41 (39.8 %) patients, including enteroviruses – 56.1 %, herpes simplex virus 1/2 (HSV-1/2) – 31.7 %, Epstein-Barr virus – 17.1 %, varicella-zoster virus (VZV) – 9.7 %, influenza A virus (H1N1) –4.9 % and mumps – 2.4 %. There was a higher proportion of PCR-positive samples in infants than in other age groups. Encephalitis and meningoencephalitis were diagnosed in 68.3 % (28/41) and 22 % (9/41) PCR-positive cases, respectively. Conclusion. The findings of this research provide insights into the clinical and viral aetiological patterns of acute CNS infections in Iran, and the importance of molecular methods to identify CNS viruses. HSV and VZV were identified as important causes of encephalitis in young children.

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“…Patients who had seizures or head imaging suggesting parenchymal involvement were presumed to have meningoencephalitis. All other patients were deemed to have meningitis [15].…”

Section: Methodsmentioning

confidence: 99%

Viral aetiology of acute central nervous system infections in children, Iran

Khalili

Rahimi

Akbari

et al. 2022

Journal of Medical Microbiology

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“…3,13 Many other investigators have also reported the high utility of imaging with CT and MRI in children with TBM. 14,15 In this study, approximately one-third of cases recovered completely, while many were lost to follow-up, and the number of deaths and recovery with sequelae was also high.Similar outcomes of TBM patients have been witnessed before as well. It was reported that children diagnosed with an advanced stage of the disease have poor outcomes.…”

Section: Discussionmentioning

confidence: 59%

Assessment of Clinicopathological Status and Outcome of Children with Tuberculous Meningitis at a Tertiary Care Hospital

Hussain

Maqbool²,

Masood³

et al. 2022

Ann Pak Inst Med Sci

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Objective: The aim of this study is to report the clinic-pathological profile of children with TBM and their treatment outcome. Methodology: A retrospective observational study was conducted in the Pediatrics Department over 6 months period. Medical records of children admitted with TBM from November 2017 to May 2018 were reviewed for data collection. Data regarding clinical presentation, laboratory investigations were recorded. Patients were treated with a standard ATT regimen, and their outcome was noted. The study was approved by hospital ethics committee. Data was entered in SPSS for statistical analysis. Results: Females were predominant 39 (55.7%) and age ranged from 4 months to 13 years in this study. Only 28 (42.0%) children were fully vaccinated and had BCG scar presence. Most TBM cases were of stage II 24 (42.8%) or stage III 29 (42.8%). The frequent symptoms were fever 61 (87.1%), rigidity/irritability 35 (50.0%), and seizures 26 (37.1%). WBCs count in CSF was found below 500 in 64 (91.4%) children. There were 55 (78.5%) children with lymphocytosis and 14 (20.0%) with polymorph nuclear cells. A CT scan was suggestive of TBM in 51 (72.8%) children. Only 21 (30.0%) cases had a complete recovery whereas 17 (24.2%) recovered with sequelae and 10 (14.2%) deaths were noted. Conclusion: TBM presents with a poor clinical and pathological state in the advanced stage of the disease, and the therapy outcome is also non-satisfactory with high mortality and sequelae posing constant challenges.

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“…The differential diagnosis of ring enhancement is very extensive. In non-immunocompromised patients, the most common diseases were metastatic disease and septic emboli, and in immunocompromised patients lymphoma was the most common ( 29 ). Metastatic disease usually has a definite history of tumor and is of equal size, usually at or near the gray-white matter junction.…”

Section: Discussionmentioning

confidence: 99%

Misdiagnosis of HIV With Toxoplasmosis Encephalopathy With Progressive Memory Loss as the Initial Symptom: A Case Report

Luo

Huang

et al. 2022

Front. Neurol.

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Toxoplasmosis encephalopathy (TE) is a kind of encephalopathy parasitic disease caused by Toxoplasma gondii. It is the most common opportunistic for central system infection in patients with acquired immunodeficiency syndrome (AIDS) or human immunodeficiency virus. Without early diagnosis and proper treatment, this opportunistic infection can be life-threatening. The common clinical manifestations of the disease include altered mental state, epilepsy, cranial nerve damage, paresthesia, cerebellar signs, meningitis, motor disorders, and neuropsychiatry. The most common presentation in about 75% of cases is a subacute episode of focal neurological abnormalities such as hemiplegia, personality changes, or aphasia. Imaging needs to be differentiated from multiple sclerosis, lymphoma, and metastases. We report a case of acquired immune deficiency syndrome complicated with toxoplasma encephalopathy with rapid progressive memory loss as the initial symptom and misdiagnosed as multiple sclerosis. Through the comprehensive analysis of the clinical symptoms and imaging examination of this disease, we hope to enhance the confidence of clinicians in the diagnosis of this disease.

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Common infectious diseases of the central nervous system—clinical features and imaging characteristics

Cited by 20 publications

References 72 publications

Viral aetiology of acute central nervous system infections in children, Iran

Viral aetiology of acute central nervous system infections in children, Iran

Assessment of Clinicopathological Status and Outcome of Children with Tuberculous Meningitis at a Tertiary Care Hospital

Misdiagnosis of HIV With Toxoplasmosis Encephalopathy With Progressive Memory Loss as the Initial Symptom: A Case Report

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