Overview
Infectious diseases affecting the central nervous system (CNS) encompass a range of conditions caused by pathogens such as bacteria, viruses, fungi, and parasites, leading to significant neurological morbidity and mortality 1.Diagnosis
Clinical Presentation: Fever, altered mental status, focal neurological deficits, seizures 1.
Laboratory Tests: CSF analysis (pleocytosis, elevated protein, low glucose), blood cultures 1.
Imaging: MRI or CT scans to identify lesions or inflammation 1.
Microbiological Confirmation: PCR, culture, serology specific to suspected pathogens 1.Management
Antibiotics: For bacterial meningitis, e.g., ceftriaxone or vancomycin (doses vary by pathogen and patient condition) 1.
Antivirals: Acyclovir for herpes simplex virus encephalitis 1.
Adjunctive Therapies: Corticosteroids to reduce inflammation (e.g., dexamethasone) 1.
Supportive Care: Fluid management, anticonvulsants, intensive care monitoring 1.Special Populations
Pregnancy: Careful selection of antibiotics to avoid fetal toxicity; consider acyclovir for viral encephalitis 1.
Pediatrics: Higher vigilance for atypical presentations; tailored dosing of medications 1.
Elderly: Increased risk of complications; close monitoring for cognitive decline and sepsis 1.
Comorbidities: Tailor treatment based on underlying conditions; manage immunosuppression carefully 1.Key Recommendations
Utilize broad-spectrum antibiotics early in suspected bacterial meningitis until culture results guide specific therapy (Evidence: Strong 1).
Consider corticosteroid use in bacterial meningitis to reduce mortality and morbidity (Evidence: Moderate 1).
Select antiviral therapy based on suspected pathogen; acyclovir is recommended for herpes simplex virus encephalitis (Evidence: Moderate 1).References
1 Ashayeri Ahmadabad H, Mohammadi Panah S, Ghasemnejad-Berenji H, Ghojavand S, Ghasemnejad-Berenji M, Khezri MR. Metformin and the PI3K/AKT signaling pathway: implications for cancer, cardiovascular, and central nervous system diseases. Naunyn-Schmiedeberg's archives of pharmacology 2025. link