In generalised infections, especially meningococcal infections, a macular or papular rash is present. In severe cases, patients may be overexcited and show features of pyramidal tract damage, such as speech problems, cranial nerve palsy, movement and balance disorders.

In young children, the course is usually subacute or acute. In the first phase, neck stiffness, meningeal symptoms and lethargy predominate. In addition to these symptoms, it is very common:

• agitation
• nausea and "slurping" vomiting
• faint screaming
• greyish skin tone
• convulsions

Treatment of bacterial neuroinfections

The standard treatment is empirical to begin with, i.e. the most effective antibiotics used in nervous system infections are used, followed by an antibiogram and the treatment is supplemented or modified by targeted antibiotic therapy.

photo ojoimages

Viral meningitis and encephalitis

Viral infections are caused by the multiplication of viruses within the brain or spinal cord. The inflammatory process can take place in the meninges, subarachnoid space, brain tissue or spinal cord. A viral infection is called aseptic inflammation because no bacterial inflammatory agent is localised in the cerebrospinal fluid.

The most common viruses causing central nervous system lesions are enteroviruses, tick-borne encephalitis virus, mumps, HIV, adenoviruses and herpes, smallpox and influenza viruses.

Features of infection with a viral aetiology:

• the majority of infections have a short course without leaving permanent sequelae
• are commonly endemic or epidemic
• highly effective vaccines exist against many aetiological agents

Depending on the form, the range of clinical symptoms is very wide:

• asymptomatic infections
• mild aseptic meningitis, characterised by headache, stiff neck, photophobia and fever
• encephalitis with disturbance of consciousness, convulsions and focal symptoms
• myelitis with involvement of both sensory and motor neurons

Treatment of viral infection of the nervous system

Treatment is mainly based on relieving the symptoms of the infection. It involves control of brain swelling, anti-inflammatory management and treatment of epileptic seizures. It is also important to maintain the acid-base and water-electrolyte balance of the body. In addition, antiviral drugs are used.