Clinical review outlines diagnostic and management frameworks for central nervous system infections, highlighting strategies across immunocompromised and travel-exposed populations.
t is fortunate that neurological infections are relatively uncommon in the UK, Europe, and North America.This is not the case in large parts of the world where infections account for a significant component of neurological practice.From the parochial perspective of neurologists working in the UK, Europe, and North America we see this burden of disease as the ''neurology of travel''.The substantially widened differential diagnosis in a sick patient who has been abroad is particularly challenging.Jeremy Day and David Laloo provide a practical systematic approach to the diagnosis and management of such patients.Most patients, however, will have acquired their infections closer to home.Viral encephalitis in terms of causes, investigation, and management is explored by Peter Kennedy.Meningitis, with an emphasis on difficult and recurrent presentations, is considered by Lionel Ginsberg.One difficult differential diagnosis of these infections is inflammatory or post-infectious encephalomyelitis or meningo-encephalomyelitis, and these are covered by Luke Bennetto and Neil Scolding.Two groups of patients at particular risk of neurological infections are patients with HIV and AIDS, and those with immunosuppression from other causes.Hadi Manjii and Robert Miller provide an approach to patients with HIV and its protean manifestations.Ian Ormerod and Charlotte Dougan offer a practical approach to patients with immunosuppression with neurological problems.Prion disease is undoubtedly infectious, albeit with a unique mechanism, and Richard Knight and Bob Will provide an overview of these diseases.Chris Douglass surfs the net for neurological infection and related websites.
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