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The Microbiology of Central Nervous System Infections

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Contents

Contributors

Preface

Section I: Central Nervous System Infections: Current Trends in Diagnosis, Treatment and Prophylaxis

Chapter 1: Meningitis: Current Understanding and Management

1. Introduction

2. Classification

2.1. Viral Meningitis1-4

2.1.1. Introduction

2.1.2. Clinical Characteristics

2.1.3. Clinical Presentation and Differential Diagnoses2-4

2.1.4. Investigations2-4

2.1.5. Management and Prognosis3,4

2.2. Bacterial Meningitis4,5

2.2.1. Introduction5,6

2.2.2. Etiopathogenesis5-7

2.2.3. The Predisposing Risk Factors

2.2.4. Clinical Presentation and Differential Diagnosis12

2.2.5. Differential Diagnosis of Bacterial Meningitis

2.2.6. Investigations5-8

2.2.7. Management5-15

2.2.8. Precautions to Prevent the Spread and Recurrence

2.2.9. Prognosis: Morbidity and Mortality5-15

2.3. Fungal Meningitis1,16

2.3.1. Introduction

2.3.2. Clinical Characteristics1,16-18

2.3.3. Differential Diagnosis

2.3.4. Management1,16,18,20

2.4. Parasitic Meningitis25,26

2.4.1. Introduction

2.4.2. Clinical Etiopathologic Characteristics

2.4.3. Clinical Presentations and Their Management25-27

2.4.4. The Prognosis

2.5. Chemical Meningitis28,29

2.5.1. Introduction

2.5.2. Etiopathogenesis

2.5.3. Clinical Presentations

2.5.4. Management and Prognosis

2.6. Neoplastic/Carcinomatous Meningitis30,31

2.6.1. Introduction

2.6.2. General Characteristics

2.6.3. Clinical Symptomatology30-32

2.6.4. Diagnosis and Differential Diagnosis32

2.6.5. Management and Prognosis30-32

3. Conclusions1-4,10,11,16,25,27,28,32

References

Chapter 2: Pathogenesis, Diagnosis, and Treatment of Central Nervous System Catheter Infections

1. Introduction

2. Hosts at Risk of Infection

3. Microbiology

3.1. Biofilm

4. Immune Response

4.1. Biofilm Evasion of Immune Response

5. Symptoms of Infection

6. Diagnosis of Infection

7. Treatment

8. Prevention

9. Conclusions and Outstanding Questions

References

Chapter 3: Molecular Diagnosis of CNS Viral Infections

1. Introduction

2. Techniques for the Diagnosis of Neuroviral Infections

2.1. Neuroimaging

2.2. Lumbar Puncture and CSF Analysis

2.3. Serology

2.4. Brain Biopsy

2.5. Molecular Methodologies

2.5.1. CSF Nucleic Acid Amplification Using Polymerase Chain Reaction

2.5.2. DNA Microarray

2.5.3. Luminex Technology

2.5.4. DNA Sequencing

3. Patents on Molecular Diagnosis of CNS Viral Infections

4. Future Scope for Diagnosis of CNS Viral Infections

References

Further Reading

Chapter 4: Vaccines Against Central Nervous System Infections: Past Achievements and Future Challenges

1. Introduction

2. Epidemiology of Meningitis

3. Epidemiology of Encephalitis

4. Vaccines Against H. influenzae

5. Vaccines Against S. pneumoniae

6. Vaccines Against N. meningitidis

7. Vaccines Against Measles and Mumps

8. Conclusion

Declaration of Interests

References

Chapter 5: Metal Nanoparticles in Management of Diseases of the Central Nervous System

1. Introduction

2. Types of CNS Diseases

2.1. Infectious CNS Diseases

2.2. Noninfectious CNS Diseases

3. Treatment Strategies in the Management of CNS Diseases and Their Limitations

4. Nanoneuromedicines and Its Necessity

5. Nanotechnology and Nanomaterials in the Management of CNS Diseases

5.1. Nanoparticles-Aided Neuroimaging

5.1.1. Magnetic Nanoparticles

5.1.2. Organic Nanomaterials

5.2. Nanomaterials-Mediated Drug Delivery

6. Nanoparticles-Based Neurotoxicity

7. Conclusions

References

Chapter 6: Natural Products as Immune System Modulators, and Against Infections of the Central Nervous System

1. Introduction

2. Natural Products as Immune Modulators

3. Natural Products Against CNS Infections

4. Conclusion and Perspectives

Acknowledgment

Conflict of Interests

References

Further Reading

Section II: Bacterial and Viral Infections of the CNS

Chapter 7: Pneumococcal Meningitis

1. Pneumococcal Disease

1.1. The Bacterium

1.2. Diagnosis and Laboratory Typing Schemes

2. Highlights of the Epidemiology of Pneumococcal Disease

3. Pneumococcal Disease Interventions

3.1. Antibiotics

3.2. Vaccines

4. Important Virulence Factors for Pneumococcal CSF Invasion

4.1. Choline-Binding Proteins

4.2. Cytoplasmic Proteins

4.3. Metal-Binding Lipoproteins

4.4. Sortase-Dependent Surface Proteins

5. Pathogenesis of Pneumococcal Meningitis

6. Genetics of Pneumococcal Meningitis

References

Chapter 8: Infections of the Central Nervous System Caused by Nontuberculous Mycobacteria

1. Introduction

2. Central Nervous System Infections Due to NTM

3. Conclusion

References

Further Reading

Chapter 9: Central Nervous System Tuberculosis

1. Introduction

2. Epidemiology

3. Microbiology

4. Pathogenesis and Pathology

5. Clinical Presentation

5.1. Tuberculous Meningitis

5.2. Tuberculous Encephalopathy

5.3. Tuberculoma

5.4. Tuberculous Brain Abscess

5.5. Spinal Tuberculosis

6. Complications

6.1. Hydrocephaly

6.2. Infarct

6.3. Tuberculous Ventriculitis

6.4. Tuberculosis Immune Reconstitution Inflammatory Syndrome

7. Diagnosis

7.1. CSF Analysis

7.2. Bacteriology

7.3. Tuberculin Skin Test

7.4. Adenosine de Aminase

7.5. Immunologic Assay

7.6. Immune Globulin Release Assay

7.7. Molecular Assay

7.8. Radiology

8. Treatment

8.1. First-Line Agents

8.2. Second-Line Agents

8.3. Neurosurgery

8.4. Drug Susceptibility

8.5. Drug-Induced Hepatitis

8.6. CNS Tuberculosis in Immunocompromised Patients

References

Chapter 10: Tick-Borne Infections of the Central Nervous System

1. Introduction

1.1. The Vector

2. Tick-Borne Viral Infections of the CNS

2.1. Tick-Borne Encephalitis Virus (TBEV)

2.1.1. The Virus, Replication, and Pathogenesis

2.1.2. Vectors, Transmission, and Epidemiology

2.1.3. Clinical Manifestations

2.1.4. Diagnosis

2.1.5. Treatment and Prevention

2.2. Powassan Virus

2.2.1. Virus, Vector Transmission, and Epidemiology

2.2.2. Pathogenesis

2.2.3. Clinical Manifestations

2.2.4. Diagnosis

2.2.5. Treatment

3. Tick-Borne Bacterial Infections of the CNS

3.1. Lyme Borreliosis

3.1.1. The Pathogen

3.1.2. Vectors, Transmission, and Pathogenesis

3.1.3. Clinical Manifestations

3.1.4. Diagnosis

3.1.5. Treatment

4. Prevention of Tick-Borne Diseases

5. Conclusion

References

Chapter 11: Interactions of Human Retroviruses With the Blood-Brain Barrier

1. Introduction

2. Retrovirus-Associated Neurological Disorders

3. Retrovirus-Associated BBB Disruption

3.1. BBB Disruption by Retroviral Infection

3.2. BBB Disruption by Soluble Cellular Factors

3.2.1. Proinflammatory Cytokines

3.2.2. MMPs

3.3. BBB Disruption by Viral Proteins

3.3.1. Soluble Viral Transactivators: HIV-1 Tat and HTLV-1 Tax

3.3.2. HIV-1 Envelope Protein gp120

3.3.3. HIV-1 Regulatory Proteins

4. Crossing the BBB

4.1. Detection of the Virus in the CNS

4.2. Crossing the BBB as a Free Viral Particle

4.3. Crossing the BBB as an Infected Cell

4.3.1. Increased Rolling of Infected Cells on the BBB Endothelium

4.3.2. Increased Adhesion of Infected Cells to the BBB Endothelium

4.3.3. Increased Transmigration of Infected Cells Through the BBB Endothelium

4.3.4. Amplification of the Infiltration Into the CNS via Chemotaxis

5. Conclusion

References

Section III: Fungal and Protozoal Infections of the CNS

Chapter 12: Recent Advances in Fungal Infections of the Central Nervous System: From Etiology to Diagnosis and Management

1. Introduction

2. Historical Aspects

3. Classification and Epidemiology

4. Pathogenesis

5. Clinicopathologic Syndromes

6. True Pathogenic Fungi Causing Infections of the CNS

6.1. Blastomycosis (North American Blastomycosis)

6.1.1. Neuropathology

6.1.2. Clinical Presentation

6.1.3. Diagnosis

6.1.4. Treatment

6.2. Coccidioidomycosis (Modeling Valley Fever)

6.2.1. Neuropathology

6.2.2. Clinical Presentation

6.2.3. Diagnosis

6.2.4. Treatment

6.3. Paracoccidioidomycosis (South American Blastomycosis)

6.3.1. Neuropathology

6.3.2. Diagnosis

6.3.3. Treatment

6.4. Histoplasmosis

6.4.1. Neuropathology

6.4.2. Clinical Presentation

6.4.3. Diagnosis

6.4.4. Treatment

6.5. Sporotrichosis

6.5.1. Neuropathology

6.5.2. Clinical Presentation

6.5.3. Diagnosis

6.5.4. Treatment

7. Opportunistic Fungi Causing Infections of the CNS

7.1. Aspergillosis

7.1.1. Neuropathology

7.1.2. Clinical Presentation

7.2. Candidiasis

7.2.1. Neuropathology

7.2.2. Clinical Presentation

7.2.3. Diagnosis

7.2.4. Treatment

7.3. Cryptococcosis (European Blastomycosis)

7.3.1. Neuropathology

7.3.2. Clinical Presentation

7.3.3. Diagnosis

7.3.4. Treatment

8. Melanized Fungi Causing Infections of the CNS

8.1. CNS Infection Due to C. bantiana

8.2. CNS Infection Due to R. mackenziei

8.3. CNS Infections Due to Other Melanized Fungi

8.4. In Vitro Antifungal Susceptibility Data of Melanized Fungi

9. Concluding Remarks

Acknowledgment

References

Further Reading

Chapter 13: Cryptococcal Meningitis and Other Opportunistic Fungal Infections of the Central Nervous System: Epidemiology ...

1. Introduction

2. Cryptococcal Meningitis

2.1. Epidemiology

2.2. Pathogenesis

2.2.1. Clinical Manifestations

2.3. Diagnosis

2.4. Treatment

3. Aspergillus and Other Medically Important Molds

3.1. CNS Aspergillosis

3.1.1. Epidemiology

3.1.2. Clinical Manifestations

3.1.3. Diagnosis and Treatment

3.2. Cerebral Mucormycosis

3.3. CNS Fusarium Infection

3.4. Scedosporium

4. Candida

4.1. Epidemiology and Pathogenesis

4.2. Clinical Manifestations

4.3. Diagnosis and Treatment

5. Endemic Fungi Infecting the CNS

5.1. Histoplasmosis

5.2. Coccidioidomycosis

5.3. Blastomycosis

5.4. Paracoccidioidomycosis

6. Other CNS Medically Important Fungi

6.1. Talaromyces

6.2. Cladosporium

6.3. Sporothrix

References

Chapter 14: The Challenge of Finding New Therapies for Sleeping Sickness

1. Introduction

2. An Overview on the Discovery of the Tsetse Fly-Trypanosome and Its Distribution

3. Cell Architecture of T. brucei

4. Life Cycle

5. What Mechanisms Does T. brucei Use to Evade the Immunological System?

6. The Traditional Treatment

7. New Advances in the Development of Treatments Against HAT

7.1. Advanced Drug Delivery Systems and HAT

7.2. Systematic Drug Repurposing

7.3. HTS and HAT

7.4. Natural Products

7.5. Drug Design and Computer-Guided Drug Design

7.6. Avoiding Drug Resistance in HAT

8. Conclusions

References

Chapter 15: A Global Problem of Toxoplasmosis

1. Introduction

1.1. Epidemiology and Transmission

2. Diagnosis of Toxoplasmosis Methods

2.1. Direct Diagnosis Methods

2.2. Indirect Diagnosis Methods

3. Treatment of Toxoplasmosis

3.1. Pyrimethamine

3.2. Sulfadiazine, Sulfamerazine, Sulfamethazine

3.3. Clindamycin

4. Vaccine Studies Against Toxoplasmosis

4.1. Inactivated Parasite

4.2. Crude, Purified Antigens, Recombinant Proteins

4.3. Live and Attenuated Parasite

4.4. DNA Vaccine

4.5. Peptide Vaccines

5. Clinical Pictures of Toxoplasmosis

5.1. Acquired Toxoplasmosis

5.2. Congenital Toxoplasmosis

5.3. Ocular Toxoplasmosis

5.4. Toxoplasmosis in Immunodeficient Patients

6. T. gondii and the CNS

7. Conclusion

References

Index

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