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Central Nervous System Infections

Overview

Central nervous system (CNS) infections are infections affecting the brain, spinal cord, or their covering (meninges). These can be caused by bacteria, fungi, viruses, and parasites. They are more commonly seen in immunocompromised individuals (those with weakened immunity, such as HIV patients or people on chemotherapy) and also in immunocompetent persons (those with normal immunity).

CNS infections can present with a variety of symptoms, depending on the cause and severity. Common signs include:

  • Fever
  • Headache
  • Stiff neck
  • Altered sensorium (confusion, drowsiness, or loss of consciousness)
  • Seizures
  • Paralysis 

The infections are triggered by different organisms:

  • Bacteria: Such as Streptococcus pneumoniae, Haemophilus influenzae, Mycobacterium tuberculosis
  • Viruses: Such as enteroviruses and herpes viruses
  • Fungi: Such as Candida, Aspergillus, Cryptococcus
  • Parasites: Such as Plasmodium and Toxoplasma

Certain conditions can increase the risk of developing CNS infections:

  • Preexisting conditions like diabetes, liver cirrhosis, stroke, and chronic alcohol abuse
  • Head trauma and injuries to the spinal cord
  • Extrinsic contamination during neurosurgical procedures, cerebrospinal fluid leakage, and drainage tube placement
  • Immunocompromised states, including end-stage HIV, systemic chemotherapy, and hereditary immunologic disorders
  • Other factors, including congenital malformations, implanted medical devices, and breaches of the blood-brain barrier

Doctors may perform several tests to confirm CNS infections, including:

  • Blood tests: abnormal WBC count and blood cultures to detect infection
  • CSF examination: by lumbar puncture to check altered cell counts, protein levels, and sugar ratio.
  • MRI/CT scans: to look for swelling, abscesses, or other structural problems. 

Treatment depends on the cause and severity of the infection:

  • Antimicrobial therapy (antibacterial/ antiviral/ antifungal)
  • Supportive care (fluid and pain management)
  • Surgery is sometimes warranted in case of mass effect caused due to abscess formation (a pocket of pus), causing pressure on the brain or spinal cord.

Seek immediate medical attention if you or someone you know develops:

  • Sudden high fever with severe headache.
  • Neck stiffness with nausea or vomiting.
  • Confusion, seizures, or fainting spells.
  • Weakness or paralysis on one side of the body.

While not all CNS infections can be prevented, the risk can be reduced by:

  • Getting recommended vaccines (e.g., meningococcal, pneumococcal, measles, mumps, rubella, and influenza vaccines).
  • Practicing good hygiene such as handwashing and safe food handling.
  • Avoiding close contact with people who have contagious infections.

CNS infections require urgent care and should be managed by a Neurologist (for diagnosis and treatment of brain and spinal cord involvement).

Disclaimer:

The information in this Health Library is for educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always consult a qualified healthcare professional with any questions about a medical condition or before starting any treatment. Use of this site and its content does not establish a doctor–patient relationship. In case of a medical emergency, call your local emergency number or visit the nearest emergency facility immediately.