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Emerg Med Clin North Am. 2016 Nov;34(4):917-942. doi: 10.1016/j.emc.2016.06.013.

Diagnosis and Treatment of Central Nervous System Infections in the Emergency Department.

Author information

1
Division of Emergency Medicine, Washington University School of Medicine, 660 South Euclid Avenue, Campus Box 8072, St Louis, MO 64110, USA.
2
Division of Emergency Medicine, Washington University School of Medicine, 660 South Euclid Avenue, Campus Box 8072, St Louis, MO 64110, USA; Division of Infectious Diseases, Washington University School of Medicine, 660 South Euclid Avenue, Campus Box 8051, St Louis, MO 63110, USA. Electronic address: sliang@dom.wustl.edu.

Erratum in

  • Erratum. [Emerg Med Clin North Am. 2017]

Abstract

Central nervous system (CNS) infections, including meningitis, encephalitis, and brain abscess, are rare but time-sensitive emergency department (ED) diagnoses. Patients with CNS infection can present to the ED with nonspecific signs and symptoms, including headache, fever, altered mental status, and behavioral changes. Neuroimaging and CSF fluid analysis can appear benign early in the course of disease. Delaying therapy negatively impacts outcomes, particularly with bacterial meningitis and herpes simplex virus encephalitis. Therefore, diagnosis of CNS infection requires vigilance and a high index of suspicion based on the history and physical examination, which must be confirmed with appropriate imaging and laboratory evaluation.

KEYWORDS:

Brain abscess; Diagnosis; Emergency department; Encephalitis; Meningitis; Treatment

PMID:
27741995
PMCID:
PMC5082707
DOI:
10.1016/j.emc.2016.06.013
[Indexed for MEDLINE]
Free PMC Article

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