Principles of Critical Care, 3e > Part V. Infectious Disorders > Chapter 52. Bacterial Infections of the Central Nervous System Allan R. Tunkel,  W. Michael Scheld

Key Points

"Bacterial infections of the central nervous system (CNS) are frequently devastating. The brain possesses several defense mechanisms (e.g., intact cranium and blood-brain barrier) to prevent entry of bacterial species; but once microorganisms have gained entry to the CNS, host defense mechanisms are inadequate to control the infection. Antimicrobial therapy is limited by the poor penetration of many agents into the CNS and by the ability of antibiotics to induce inflammation in the CNS via their bacteriolytic action, thereby contributing to brain damage. We review meningitis, brain abscess, subdural empyema, epidural abscess, and intracranial thrombophlebitis, with an emphasis on recent developments in diagnosis and therapy as they pertain to the care of the critically ill patient...."