Bacterial, Fungal, and Parasitic Infectious Diseases of the Central Nervous System: Pathogenesis and Pathophysiology
Keywords:
bacterial, fungal, paraasitic, meningitis, meningoencephalitis, neurocysticercosis, abscess, neurodegeneration, pathophysiology, treatment, complicationsAbstract
Background: Central nervous system (CNS) infections encompass a broad scope of diseases caused by the pathological invasion of the blood-brain barrier (BBB). Specific virulence factors of micro- and macro-organism organisms successfully enable their bypassing of immune surveillance.
Aim: This paper aims to seek a deeper understanding of the trends in the pathophysiology of infectious CNS disease by various pathogens and to enable advancements in identification and treatment that can benefit the prognosis of all affected patients.
Methods: A narrative approach was employed to explore the pathophysiology, risk factors, complications, and prognosis of infectious categories. Exclusion criteria were applied and a relevant timeline was established from 2007 to 2023.
Results: Trends were established amongst routes of inoculation, proteins being used to bypass the BBB, inflammatory processes, risk factors, and epidemiology present amongst CNS infections. Clinical presentations can be synonymous with different infectious pathogens and diagnostic tools, most notably the PCR and CSF analysis, help to accurately diagnose and ensure proper treatment of CNS infections.
Downloads
References
Sellner, Johann, Martin G. Täuber, and Stephen L. Leib. "Pathogenesis and pathophysiology of bacterial CNS infections." Handbook of clinical neurology 96 (2010): 1-16. DOI: 10.1016/S0072-9752(09)96001-8
Shih, R., & Koeller, K. K. (2015). Bacterial, fungal, and parasitic infections of the central nervous system: Radiologic-Pathologic Correlation and Historical Perspectives:From the Radiologic Pathology Archives. Radiographics, 35(4), 1141–1169. DOI: 10.1148/rg.2015140317
Hoffman O, Weber RJ. Pathophysiology and treatment of bacterial meningitis. Ther Adv Neurol Disord. 2009 Nov;2(6):1-7. doi: 10.1177/1756285609337975. PMID: 21180625; PMCID: PMC3002609. DOI: 10.1177/1756285609337975
Runde TJ, Anjum F, Hafner JW. Bacterial Meningitis. [Updated 2023 Aug 8]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK470351/
Alanazi AH, Chastain DB, Rudraraju M, et al. A multi-arm, parallel, preclinical study investigating the potential benefits of acetazolamide, candesartan, and triciribine in combination with fluconazole for the treatment of cryptococcal meningoencephalitis. Eur J Pharmacol. 2023;960:176177. doi:10.1016/j.ejphar.2023.176177
Walsh NM, Botts MR, McDermott AJ, Ortiz SC, Wüthrich M, Klein B, Hull CM. Infectious particle identity determines dissemination and disease outcome for the inhaled human fungal pathogen Cryptococcus. PLoS Pathog. 2019 Jun 27;15(6):e1007777. doi: 10.1371/journal.ppat.1007777. PMID: 31247052; PMCID: PMC6597114.
Bokhari MR, Mesfin FB. Brain Abscess. [Updated 2022 May 11]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK441841/
Hsi-Lung Hsieh, Chuen-Mao Yang, "Role of Redox Signaling in Neuroinflammation and Neurodegenerative Diseases", BioMed Research International, vol. 2013, Article ID 484613, 18 pages, 2013. https://doi.org/10.1155/2013/484613
Kalyan M, Tousif AH, Sonali S, Vichitra C, Sunanda T, Praveenraj SS, Ray B, Gorantla VR, Rungratanawanich W, Mahalakshmi AM, et al. Role of Endogenous Lipopolysaccharides in Neurological Disorders. Cells. 2022; 11(24):4038. https://doi.org/10.3390/cells11244038
Kumar, Rakesh. "Meningitis." Himalayan Journal of Health Sciences (2021): 33-47. PMID: 29261975 Bookshelf ID: NBK470351
Winegarner, James H., and Jeffrey Wittkopp. "Streptococcus pneumoniae meningitis associated with over-the-counter sinus irrigation." Cureus 12.5 (2020). DOI: 10.7759/cureus.8258
Eichner, Hannes. Rna-Mediated Gene Regulation in Neisseria Meningitidis and Other Nasopharyngeal Pathogens. Karolinska Institutet (Sweden), 2021. Available at https://openarchive.ki.se/xmlui/handle/10616/47648
Gonzales, Joyce, et al. "Streptococcus pneumoniae and its virulence factors H2O2 and pneumolysin are potent mediators of the acute chest syndrome in sickle cell disease." Toxins 13.2 (2021): 157. DOI: 10.3390/toxins13020157
Ibrahim, Hamdy, et al. "Meningococcal meningitis, a life-threatening disease with a dangerous skin rash: two case reports." The Egyptian Journal of Internal Medicine 35.1 (2023): 63. DOI https://doi.org/10.1186/s43162-023-00249-6
Shahan, Brian, Edwin Y. Choi, and Gilberto Nieves. "Cerebrospinal fluid analysis." American Family Physician 103.7 (2021): 422-428. Available at https://www.aafp.org/pubs/afp/issues/2021/0401/p422.pdf
Le Turnier, Paul, et al. "Empirical treatment in acute bacterial meningitis: a plea for high doses of cefotaxime or ceftriaxone." Antimicrobial Agents and Chemotherapy 67.4 (2023): e00012-23. DOI: 10.1128/aac.00012-23
Singhi, Pratibha, and Arushi Gahlot Saini. "Fungal and parasitic CNS infections." The Indian Journal of Pediatrics 86 (2019): 83-90. DOI: 10.1007/s12098-017-2487-x
Linder, Kathleen A., and Carol A. Kauffman. "Histoplasmosis: Epidemiology, diagnosis, and clinical manifestations." Current Fungal Infection Reports 13 (2019): 120-128. https://doi.org/10.1007/s12281-019-00341-x
Mazi, Patrick B., Adriana M. Rauseo, and Andrej Spec. "Blastomycosis." Infectious Disease Clinics 35.2 (2021): 515-530. Available at https://doi.org/10.1007/s13225-018-0403-y
Kollath, Daniel R., Karis J. Miller, and Bridget M. Barker. "The mysterious desert dwellers: Coccidioides immitis and Coccidioides posadasii, causative fungal agents of coccidioidomycosis." Virulence 10.1 (2019): 222-233. DOI: 10.11114/ijsss.v8i4.4891
Sharma, Ashok Kumar, et al. "AMPHOTERICIN-B: A DRUG APPROACH IN FUNGAL TREATMENT.” Available at http://impactfactor.org/PDF/IJCPR/14/IJCPR,Vol14,Issue1,Article2.pdf
Tenforde, Mark W., et al. "Mortality from HIV‐associated meningitis in sub‐Saharan Africa: a systematic review and meta‐analysis." Journal of the International AIDS Society 23.1 (2020): e25416. DOI: 10.1002/jia2.25416
Deganich, Myla, Crystal Boudreaux, and Imaan Benmerzouga. "Toxoplasmosis infection during pregnancy." Tropical Medicine and Infectious Disease 8.1 (2022): 3. DOI: 10.3390/tropicalmed8010003
Garcia, Hector H., Armando E. Gonzalez, and Robert H. Gilman. "Taenia solium cysticercosis and its impact in neurological disease." Clinical microbiology reviews 33.3 (2020): 10-1128. DOI: 10.1128/CMR.00085-19
Moseman, E. Ashley. "Battling brain-eating amoeba: Enigmas surrounding immunity to Naegleria fowleri." PLoS pathogens 16.4 (2020): e1008406. DOI: 10.1371/journal.ppat.1008406
Garcia, Hector H. "Parasitic infections of the nervous system." Continuum (Minneapolis, Minn.) 27.4 (2021): 943. DOI: 10.1212/CON.0000000000000986
Khan, Khadija, and Wajihullah Khan. "Congenital toxoplasmosis: An overview of the neurological and ocular manifestations." Parasitology International 67.6 (2018): 715-721. DOI: 10.1016/j.parint.2018.07.004
Grace, Eddie, Scott Asbill, and Kris Virga. "Naegleria fowleri: pathogenesis, diagnosis, and treatment options." Antimicrobial agents and chemotherapy 59.11 (2015): 6677-6681. DOI: 10.1128/AAC.01293-15
Harrell, Meredith, and Petros E. Carvounis. "Current treatment of toxoplasma retinochoroiditis: an evidence-based review." Journal of ophthalmology 2014 (2014). DOI: 10.1155/2014/273506
Mungroo, Mohammad R., et al. "Brain-eating amoebae infection: Challenges and opportunities in chemotherapy." Mini reviews in medicinal chemistry 19.12 (2019): 980-987. DOI: 10.2174/1389557519666190313161854
Abanto, Jesus, et al. "Mortality in parenchymal and subarachnoid neurocysticercosis." The American Journal of Tropical Medicine and Hygiene 105.1 (2021): 176. DOI: 10.4269/ajtmh.20-1330
Kalantari, Narges, et al. "Toxoplasma gondii infection and spontaneous abortion: A systematic review and meta-analysis." Microbial Pathogenesis 158 (2021): 105070. DOI: 10.1016/j.micpath.2021.105070
Additional Files
Published
License
Copyright (c) 2023 Natasha Hastings, James Hanna, Emon Javadi, Mykhalo Dudkin, Rami Matar, Denis Selimovic (Author)
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Authors retain copyright to their work published in the IRABCS journal under the Creative Commons Attribution Non-Commercial No Derivatives License (CC BY-NC-ND 4.0).