Despite diverse causes of focal suppurative nervous system infections, a few mostly gram-positive bacterial species predominate, usually related to the infectious portal. Risk factors include cyanotic congenital heart disease (CCHD), hematogenous spread from distant infected sites, penetrating trauma/instrumentation, or contiguous…
Inflammation of the central or peripheral nervous system can produce a myriad of symptoms depending on the site of injury. The inflammation often arises during, or in response to, an infection. However, the same syndrome can be seen when there…
Encephalitis is inflammation of the brain parenchyma. Typical signs and symptoms include fever, headache, and altered mental status. Patients often will have associated meningeal inflammation (i.e., meningoencephalitis ) . For the purposes of this chapter, the terms encephalitis and meningoencephalitis…
The term acute aseptic meningitis (AM) was introduced in 1925 to describe a self-limited central nervous system (CNS) syndrome characterized by acute onset of fever and meningeal irritation in which the cerebrospinal fluid (CSF) exhibited a mononuclear pleocytosis and was…
Recurrent meningitis typically is defined as two or more separate episodes of meningitis and associated cerebrospinal fluid (CSF) pleocytosis that occur weeks to months apart with full recovery between events. In contrast, recrudescence or relapsed meningitis represents the persistence of…
Chronic meningitis is defined arbitrarily as persistent or progressive signs and symptoms of meningeal irritation plus cerebrospinal fluid (CSF) pleocytosis lasting for at least 4 weeks without improvement. The symptoms of chronic meningitis vary, but most patients have a gradual…
Etiologic Agents and Epidemiology Haemophilus influenzae type b and Streptococcus pneumoniae In otherwise healthy children, the three most common organisms causing hematogenously acquired acute bacterial meningitis worldwide are Streptococcus pneumoniae, Neisseria meningitidis, and Haemophilus influenzae type b (Hib). Previously, Hib…
Pericarditis is inflammation of the pericardium and proximal great vessels. The etiologies of pericarditis are diverse and include infectious and noninfectious causes. Pericarditis may be acute, subacute, chronic, or recurrent in presentation. It may be the sole manifestation of a…
Myocarditis is an inflammatory disease of the heart muscle that may progress to dilated cardiomyopathy. The condition can manifest with a range of clinical presentations from nonspecific systemic symptoms to fulminant heart failure or sudden death. There is continued debate…
Acknowledgements The authors acknowledge substantial use of material from this chapter in the last edition. The American Heart Association (AHA) and the European Society of Cardiology, as well as other national societies, provide updated scientific statements on many of the…