This book offers a comprehensive review of the most common infectious diseases that affect the nervous system. Written by international experts, it provides a guide to clinicians for accurately diagnosing and treating these challenging syndromes.
Organized into six sections, the book presents didactic, up-to-date information on the following topics relating to central nervous system (CNS) infections: diagnosis and evaluation of the patient, bacterial, viral, fungal and mycobacterial infections, disorders of the spinal cord, and a myriad of miscellaneous infections. Chapters specifically reflect and look to resolve the common obstacles clinicians face in the field, such as having unknown etiologies on the majority of CNS infections, insensitive and slow microbiological techniques, an increasing number of immunosuppressed individuals with atypical presentations and pathogens, and a lack of standardized diagnostic algorithms.
A complex yet accessible addition to the Current Clinical Neurology Series, Neurological Complications of Infectious Diseases invaluably examines a wide range of infections that have neurological complications and sequelae.
Author(s): Rodrigo Hasbun, Karen C. Bloch, Adarsh Bhimraj
Series: Current Clinical Neurology
Publisher: Humana
Year: 2020
Language: English
Pages: 387
City: New York
Preface
Series Editor’s Introduction
Contents
Contributors
Part I: Diagnosis and Evaluation of the Patient with a CNS Infection
Chapter 1: Diagnostic Approach to a Patient with Suspected CNS Infection
1: Where Is the Inflammation?
2: How Long Has It Been Going on?
3: Is It Community Acquired or Healthcare Acquired?
4: What Is the Exposure or Epidemiological History?
5: Is the Patient a “Normal Host” or an Immunocompromised Host?
6: Is It an Acute Severe Infection or a Chronic Stable Infection?
7: What Is the Type of CSF Inflammatory Response?
Diagnostic Testing in a Patient with a CNS Inflammatory or Infectious Syndrome
A Clinical Syndrome Based Approach to CNS Infections
Acute Meningitis
Recurrent Acute Meningitis
Chronic Meningitis
Encephalitis
Myelitis or Myelo-Radiculitis
Space Occupying Rim Enhancing Lesions in the Brain
Stroke or Stroke Like Syndromes from Infectious and Inflammatory Etiologies
References
Chapter 2: Molecular Diagnostics in Central Nervous System Infections
Conventional Techniques
Microscopic Examination
Culture
Antigen Testing
Serology
Molecular Diagnostics
Monoplex Assays
Multiplex Assays and Syndromic Panel Testing
Next Generation Sequencing
Conclusion
References
Chapter 3: Neurological and Psychiatric Side Effects of Antimicrobials
Drugs and Their Side Effects
β-Lactams
Penicillins
Cephalosporins
Carbapenems
Macrolides
Fluoroquinolones (FQs)
Aminoglycosides (AGs)
Polymyxins
Tetracyclines
Glycylcycline
Sulfonamides
Glycopeptides
Lipoglycopeptides
Lipopeptide
Oxazolidinones
Lincosamide
Nitroimidazole
Nitrofurans
Antimycobacterials, First-Line Therapy
Isoniazid (INH) and Pyridoxine (Vitamin B6)
Rifampin/Rifampicin
Ethambutol
Other Anti-infectives
Antifungals
Antiparasitics
Antimalarials
Antivirals
Anti-retrovirals
Management
Conclusion
References
Part II: Bacterial Infections
Chapter 4: Neurological Complications of Infective Endocarditis
Epidemiology and Outcomes of Neurologic Events in IE
Pathophysiology of Neurologic Complications in IE
Brain MRI in Management of IE Patients
Right Timing of Cardiac Surgery in IE Patients with Neurologic Complications
Specific Management of Mycotic Aneurysms
Antibiotic Therapy and Neurologic Complications
Uncertainties About Antithrombotic Therapies
Conclusions
References
Chapter 5: Neurobrucellosis
Epidemiology
Pathogenesis
Clinical Characteristics
Clinical Features of Brucellosis
Common Neurologic Clinical Features
Rare Neurologic Clinical Features
Diagnosis
Differential Diagnosis
Treatment
Prognosis
References
Chapter 6: Neurological Complications of Syphilis
Epidemiology
Clinical Characteristics
Clinical Syndromes
Asymptomatic Neurosyphilis
Symptomatic Meningitis and Meningovascular Syphilis
General Paresis
Tabes Dorsalis
Ocular Syphilis
Atypical Manifestations
HIV Co-Infection
Diagnosis
Serologic Tests
CSF Investigations
Risk Factors
Treatment
Pathophysiology
Future Work
References
Part III: Viral Infections
Chapter 7: Arboviral Central Nervous System Infections
Domestic Arboviruses Causing Acute Central Nervous System Infections
Flaviviridae
West Nile Virus
St. Louis Encephalitis Virus
Powassan Virus
Peribunyaviridae
La Crosse Virus
Jamestown Canyon Virus
Cache Valley Virus
Togaviridae
Eastern Equine Encephalitis Virus
Western Equine Encephalitis Virus
Non-domestic Arboviruses Causing Acute Central Nervous System Infections Among Travelers
Clinical Laboratory and Neuroimaging Findings
Diagnosis of Arboviral Diseases
Treatment
Prevention
Personal Protective Measures
Arboviral Vaccines
Blood Donation Screening
References
Chapter 8: Update on HSV and VZV Encephalitis in Adults
The Viruses
Types of Human Herpes Virus (HHV)
Pathophysiology
HSV Encephalitis (HSVE)
VZV Encephalitis
Importance of Resistance to Viral Infection
Interferon Is of Major Importance in Fighting Viral Infection
Chemokines
Epidemiology Worldwide
Clinical and Imaging Presentations
HSV
VZV
Biological Diagnosis
Treatment
Antiviral Treatment
HSVE
VZV Encephalitis
Supportive Treatment
Outcome
Case Fatality Rate
Outcome and Sequelae Following HSE Et VZV Encephalitis
Auto-Immune Disorders Following HSVE
Conclusion
References
Chapter 9: Neurologic Disease in HIV Infection
Human Immunodeficiency Virus
Neuropathogenesis
HIV-Associated Neurocognitive Disorder
Diagnostic Criteria
HAND Demographics
Comorbidities and HAND
Patient Presentation: History and Examination
Patient Work-Up: Serum, CSF & Neuroimaging
Other Neuroimaging Biomarkers
Plasma and CSF Biomarkers
Treatment
CD8+ Encephalitis
Background
Diagnosis and Treatment
Myelopathic Manifestations of HIV
HIV-Associated Acute Transverse Myelitis
Background
Diagnosis
Treatment
HIV Vacuolar Myelopathy
Background
Diagnosis
Treatment
Immune Reconstitution Related Syndrome in the Nervous System
CSF Escape
CD8+ T-Cell Encephalitis
Toxoplasmosis
Background
Presentation
Diagnosis
Treatment
Primary CNS Lymphoma
Background
Presentation
Diagnosis
Treatment
Cytomegalovirus
Background
Diagnosis
Treatment
Varicella Zoster Virus
Background
Diagnosis
Treatment
Progressive Multifocal Leukoencephalopathy
Background
Diagnosis
Treatment
Cryptococcal Infection
Background
Diagnosis
Treatment
Special Considerations: IRIS and Drug Interactions
Peripheral Nervous System Disorders in HIV
References
Part IV: Fungal and Mycobacterial Infections
Chapter 10: Fungal Infections of the Brain
Yeast Infection
Cryptococcal Meningoencephalitis
Candida
Dimorphic Fungi
Histoplasmosis
Coccidioidomycosis
Blastomycosis
Other
Mold Infection
Aspergillosis
Mucormycosis
Emergent Fungi
Dematiaceous Molds
Blastomyces helicus
Antifungal Agents and the CNS
Conclusions
References
Chapter 11: Neurocysticercosis and Other CNS Helminthic Infections
CNS Diseases Caused by Cestodes
Neurocysticercosis
Epidemiology
Life Cycle/Parasitology
Pathogenesis/Pathology
Clinical Manifestations and Classifications
Parenchymal Disease
Extraparenchymal Disease
Diagnosis
Management
Prevention
Echinococcosis
Sparganosis
CNS Diseases Caused by Nematodes
Angiostrongyliasis
Gnathostomiasis
Trichinellosis
Strongyloidiasis
Toxocariasis
Baylisascariasis
CNS Diseases Caused by Trematodes
Schistosomiasis
Paragonimiasis
References
Chapter 12: Free-Living Ameba
Primary Amebic Meningoencephalitis (PAM) Caused by Naegleria fowleri
Microbiology/Pathogenesis
Epidemiology
Clinical Presentation
Diagnosis
Treatment
Prevention
Amebic Encephalitis Caused by Balamuthia mandrillaris
Microbiology/Pathogenesis
Epidemiology
Clinical Presentation
Diagnosis
Treatment
Prevention
Amebic Encephalitis Caused by Acanthamoeba spp.
Microbiology/Pathogenesis
Epidemiology
Clinical Presentation
Diagnosis
Treatment
Prevention
References
Part V: Disorders of the Spinal Cord
Chapter 13: Bacterial Infections of the Spine
Infections of the Spine
Anatomy of Spine Infections
Pathophysiology of Spine Infections
Epidemiology of Spine Infections
Microbiology
Risk Factors and Clinical Presentation
Diagnosis
Imaging
Establishing Microbiological Etiology
Treatment
Outcome
Summary
References
Chapter 14: Infectious Primary Myelitis
Myelitis
Viruses
Herpesviruses
Enteroviruses
Flaviviruses
Retroviruses
Other Viruses
Bacteria
Syphilis
Mycoplasma Pneumoniae
Brucellosis
Neuroborreliosis
Tuberculosis
Parasites
Schistosomiasis
Fungal Diseases
Conclusions
References
Chapter 15: Post-infectious Encephalomyelitis
Epidemiology
Clinical Features
Diagnostic Testing
Neuroimaging
Lumbar Puncture
Laboratory Studies
Immunopathogenesis
Pathology
Diagnosis
Diagnostic Criteria
Monophasic ADEM
Multiphasic ADEM
Variant and Recurrent Forms of ADEM (Fig. 15.2)
Differential Diagnosis and Evaluation
Treatment (Fig. 15.6)
Acute Treatment
Maintenance Immunosuppression If High Risk for Relapse
Prognosis
Risk of Relapse
Motor Sequelae
Neuropsychological Sequelae
Risk of Evolution to Multiple Sclerosis
Conclusion
References
Part VI: Miscellaneous Infections
Chapter 16: Tick-Borne Infections of the Central Nervous System
Bacterial Infections
Anaplasmosis
Epidemiology
Clinical
Neurologic Manifestations
Diagnosis
Treatment
Ehrlichiosis
Epidemiology
Clinical
Neurologic Manifestations
Diagnosis
Treatment
Lyme Disease
Epidemiology
Clinical
Neurologic Manifestations
Diagnosis
Treatment
Rocky Mountain Spotted Fever
Epidemiology
Clinical
Neurologic Manifestations
Diagnosis
Treatment
Tularemia
Epidemiology
Clinical
Neurologic Manifestations
Diagnosis
Treatment
Viral Infections
Colorado Tick Fever
Epidemiology
Clinical
Diagnosis
Treatment
Emerging Tick-Borne Infections
Parasitic Infections
Babesiosis
Epidemiology
Clinical
Neurologic Complications
Diagnosis
Treatment
References
Chapter 17: CNS Whipple’s Disease
History
Epidemiology
Pathophysiology
Clinical Presentation
Differential Diagnosis
Diagnosis
Cerebrospinal Fluid (CSF) Analysis
Biopsy
Radiology
Treatment
Complications
Follow Up
Prognosis
References
Chapter 18: Prion Diseases
Epidemiology
Types of Prion Disease
Sporadic Prion Disease
Sporadic Creutzfeldt-Jakob Disease (sCJD)
Sporadic Fatal Insomnia (sFI)
Variably Protease Sensitive Prionopathy (VPSPr)
Genetic Prion Disease (gPD)
Genetic Creutzfeldt-Jakob Disease (gCJD)
Fatal Familial Insomnia (FFI)
Gerstman-Sträussler-Scheinker Syndrome (GSS)
Acquired Prion Disease
Kuru
Variant Creutzfeldt-Jakob Disease (vCJD)
Iatrogenic Creutzfeldt-Jakob Disease (iCJD)
Diagnosing Prion Disease
Electroencephalogram (EEG)
Cerebrospinal (CSF) Protein Tests
Brain Magnetic Resonance Imaging (MRI)
Real Time Quaking Induced Conversion (RT-QuIC)
Infection Control for Prion Diseases
Emerging Threats
Conclusions
References
Index
