Infections of the central nervous system

Am J Med Sci. 1992 Dec;304(6):379-91. doi: 10.1097/00000441-199212000-00010.


Infections of the central nervous system are common, serious medical conditions. One hundred consecutive adult cases with purulent meningitis of known etiology encountered by the Medical Service at Parkland Memorial Hospital were reviewed. Streptococcus pneumoniae was the most common pathogen (56 cases), followed by Neisseria meningitidis (16 cases) and Listeria monocytogenes (seven cases). Hemophilus influenzae, Staphylococcus aureus, and streptococci each accounted for five cases. An additional 15 patients had purulent meningitis with a pathogen being isolated. Twenty five purulent meningitis cases of known etiology after trauma or neurosurgery were reviewed. Staphylococcus aureus (five cases), Staphylococcus epidermidis (four cases), and gram negative bacilli (14 cases) were the most common pathogens. Review of intracranial suppurative infections demonstrated advances in microbiology, antibiotic therapy, and imaging, leading to improvements in therapy. Subdural empyema continues to be a difficult diagnosis to make and apparently is related to the anatomic pathology of the infectious process. To illustrate salient features about granulomatous meningitis and encephalitis, cases of tuberculous meningitis, herpes simplex encephalitis, St. Louis encephalitis, and encephalitis of undetermined etiology are presented and discussed.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Adolescent
  • Adult
  • Brain Abscess / drug therapy
  • Brain Abscess / microbiology
  • Brain Abscess / physiopathology
  • Brain Diseases / diagnosis
  • Brain Diseases / drug therapy
  • Brain Diseases / microbiology*
  • Brain Diseases / physiopathology
  • Encephalitis / diagnosis
  • Encephalitis / drug therapy
  • Encephalitis / microbiology
  • Encephalitis / physiopathology
  • Female
  • Herpes Simplex / complications
  • Humans
  • Male
  • Meningitis, Bacterial / diagnosis
  • Meningitis, Bacterial / drug therapy
  • Meningitis, Bacterial / microbiology
  • Meningitis, Bacterial / physiopathology
  • Middle Aged
  • Pregnancy
  • Retrospective Studies