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Central Nervous System Infections

Dr Jasper Chan

Introduction

The major clinical syndromes of central nervous system infections include the following: Meningitis: inflammation of the leptomeninges (arachnoid and pia mater) Encephalitis: inflammation of brain parenchyma Brain abscess Subdural empyema and epidural abscess Suppurative intracranial thrombophlebitis Shunt infection

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Meningitis

A. Clinical Manifestations The classic triad of fever, headache and meningeal irritation (neck stiffness) sometimes do not occur altogether. Occasionally, patients may also have altered sensorium. Meningitis can be classified into acute, subacute, and chronic meningitis. Acute meningitis is characterized by onset of symptoms over ...

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Encephalitis

A. Clinical manifestations The clinical manifestations of encephalitis may be similar to those of meningitis. However, altered level of consciousness is a predominant sign. It can range from mild lethargy to deep coma. Moreover, focal or generalized seizures occur in many patients with encephalitis, especially ...

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Brain Abscess

A. Clinical manifestations The clinical course of brain abscess ranges from indolent to fulminant. Most clinical manifestations are not due to the systemic signs of infection, but rather to the size and site of the abscess. Headache is the most common presenting symptom. Other symptoms ...

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Subdural Empyema and Epidural Abscess

A. Clinical manifestations Cranial subdural empyema: fever, headache, altered mental status, symptoms and signs of raised intra-cranial pressure, meningeal irritation or focal irritation. Spinal subdural empyema: back pain, radiculopathy and spinal cord compression. Cranial epidural abscess: fever and headache (can be quite asymptomatic), focal neurological ...

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