Central nervous system (CNS) infections include a spectrum of diseases such as meningitis, encephalitis, brain abscess, and healthcare-associated ventriculitis/meningitis. These conditions are associated with significant morbidity and mortality, requiring rapid diagnosis and prompt, targeted intervention.
I. Types of CNS Infections
Infection Type
Most Common Causes
Key Features/Notes
Meningitis
Bacterial: S. pneumoniae, N. meningitidis, H. influenzae, L. monocytogenes. Viral: enteroviruses, HSV, VZV, HIV
Neck stiffness, photophobia, fever, headache, altered mental status
Encephalitis
HSV-1, arboviruses (West Nile, Japanese, Tick-borne), VZV, CMV, EBV, autoimmune, post-infectious
Monitor for complications: Hearing loss, neurologic sequelae, hydrocephalus
VI. Special Cases
Patient Group
Key Pathogens / Considerations
Neonates
GBS, E. coli, Listeria, HSV
Elderly
S. pneumoniae, L. monocytogenes, Gram-negatives
Immunocompromised
CMV, HSV, JC virus (PML), fungi
Returning travelers
Arboviruses (WNV, JEV), malaria, TB
VII. References
Shrestha J. CNS Infections. StatPearls [Internet]. 2023.
WHO guidelines on meningitis diagnosis, treatment and care. Geneva: World Health Organization; 2025 Apr 9.
Dagra A, et al. Encephalitis and Meningitis: Indications for Intervention. JClinical.org. 2023 Apr 25.
Mayo Clinic. Encephalitis—Diagnosis and treatment. 2024 May 15.
Shin SH, Kim KS. Treatment of Bacterial Meningitis: An Update. Expert Opin Pharmacother. 2012 Oct;13(15):2189-206.
Sigfrid L, et al. Clinical guidelines for community-acquired CNS infections in Europe: A systematic review. JAC. 2019 Sep 5.
CDC. Tick-borne encephalitis—Treatment and prevention. 2024 May 13.
Hart CA. Management of bacterial meningitis. J Infect. 1993.
Reference
Mentor, Pharmacology. CNS infections and their treatment. Pharmacology Mentor. Available from: https://pharmacologymentor.com/cns-infections-and-their-treatment/. Accessed on October 14, 2025 at 15:24.
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