Issues in Central Nervous System Infections

Part of the Emerging Infectious Diseases of the 21st Century book series (EIDC)

Bacterial meningitis is a serious, potentially fatal infection, which requires prompt diagnosis and immediate appropriate management. In the 20th century the annual incidence of bacterial meningitis ranges from approximately 3 per 100,000 population in the United States,1 to 45.8 per 100,000 in Brazil,2 to 500 per 100,000 in the “Meningitis belt” (sub-Sahara) of Africa.3

Despite the availability of effective antimicrobials the case fatality rate of bacterial meningitis remain high, with a 25% all-cause mortality rate between 1962 and 1988 for community-acquired meningitis in adults (蠅16 years).4. In the pediatric population although the case fatality rate is between 5% and 10%,5. severe morbidity with long-term neurological sequelae occurs in 30% of newborn and young infants and 15–20% of older children.5 These sequelae can result from parenchymal brain damage (causing cognitive deficits, seizure disorder, learning disabilities, behavior problems, paresis, spasticity), cranial nerve dysfunction (causing hearing deficit, visual impairment, ataxia), and increased intracranial pressure (ICP; causing hydrocephalus). Bacterial meningitis is one of the leading causes of acquired deafness in children in the United States,6 with incidence of significant hearing deficit ranging from 5% to 20%.7,8


Lumbar Puncture Bacterial Meningitis Cryptococcal Meningitis Central Nervous System Infection Pneumococcal Meningitis 
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