Critical Matters CNS Infections
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Jun 8, 2023 In this engaging conversation, Dr. Catherine Albin, a neurointensivist at Emory University, dives into the complexities of CNS infections like meningitis and encephalitis. She highlights the need for ICU clinicians to be vigilant due to the high morbidity associated with these conditions. Albin discusses risk factors, diagnostic strategies, and effective treatment protocols, emphasizing the importance of early intervention with antibiotics and acyclovir. Additionally, she elaborates on post-ICU recovery and the nuanced decision-making around lumbar punctures and neuroimaging.
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Rarity Doesn’t Lower Stakes
- CNS infections are rare but cause high morbidity and mortality, so clinicians must keep them in mind.
- Missing the diagnosis has devastating consequences, so vigilance matters.
Evaluate Host Risk First
- Assess host risk factors like immunosuppression, recent neurosurgery, CSF leak, or EVD before diagnosing meningitis.
- Treat suspicion more aggressively in high-risk hosts because their infection risk is much higher.
Define Meningitis Versus Encephalitis
- Meningitis is inflammation of meninges; encephalitis is brain parenchyma inflammation and often harder to detect.
- Aseptic meningitis is a confusing term; better to think infectious versus non-infectious.
