Brain infections

 

Brain infections are emergencies requiring urgent hospitalization. Infective organisms of many kinds, even fungi and amoebae, can affect the central nervous system. Acute meningitis is an acute infection of the membranes covering the brain by bacterial organisms like S. pneumoniae. In tuberculous meningitis there is often a history of several weeks of less severe symptoms. Encephalitis is caused by viruses- like the herpes, rabies or Japanese encephalitis virus. Brain abscess is often caused by multiple bacteria. ( Worms can produce cysts, which mimic the symptoms of tumors or other space-occupying lesions in the brain.) The symptoms in infections include fever, headache, vomiting, neck stiffness (gentle attempts to turn the neck or lift the head suggests rigidity), back stiffness, disturbances of sensations and mental faculties including confusion and incoherence, and a severely ill appearance. Investigations include blood tests and culture, other lab tests including those that show the presence of antigens from the infecting organism, and CT scan or other imaging. A key investigation is examination and culture of CSF; but as there could be a major risk from lumbar puncture, initially other tests are relied on. Treatment includes life-saving efforts, relieving raised pressure in the brain and controlling infection.

Note: 1. Any infection involving the brain is serious and requires emergency hospitalization.

2. All symptoms may not be present together; therefore any combination of the above symptoms should arouse suspicion. Consult promptly in hospital.

3. The symptoms of any brain infection, particularly encephalitis, may progress rapidly - even within 24 hours - to become life threatening.

     

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Neurological examination
Anosmia
Cranial nerves
Horner's syndrome
Olfactory nerve
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Optic neuritis
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