Central nervous system infections in intensive care patients

Many challenges exist in the recognition, diagnosis and management of various central nervous system (CNS) infections amongst intensive care patients. The following review article provides a framework for the understanding and approach to the diagnosis and management of CNS infections in such patients. Important CNS infection syndromes namely meningitis, encephalitis, cerebral/subdural abscess and epidural abscess are discussed. Common clinical features of each syndrome are highlighted, and important aetiological agents and differential diagnoses considered, in the setting of both community and hospital-onset infections. CNS infections in immune competent and immunocompromised hosts are also discussed in detail. Importantly, a logical approach to the initial work up of various CNS infection syndromes is provided and empiric antimicrobial choices are suggested in accordance with published guidelines.