Bacterial Infections of the Central Nervous System.

PURPOSE OF REVIEW: Bacterial infections of the central nervous system are neurologic emergencies. Prompt recognition and treatment are essential not only to prevent mortality, but also to decrease neurologic sequelae. This article focuses on the two most common central nervous system bacterial infections, bacterial meningitis and spinal epidural abscess.

RECENT FINDINGS: Two outbreaks of serogroup B meningococcal disease have occurred on US college campuses. The meningococcal vaccine given to young adults does not contain serogroup B.

SUMMARY: In bacterial meningitis and in bacterial spinal epidural abscess, the identification of and eradication of the pathogen with antimicrobial therapy is the easy part. It is the recognition of the disorder, the understanding of which diagnostic studies to obtain and their limitations, and the management of the neurologic complications that require the expertise of a neurologist.