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Brain Infection
Brain Infection
Brain Infection
Signs and symptoms of a brain infection depend to some extent on the type of infection.
Viral meningitis usually causes much milder symptoms than bacterial meningitis, which can
be fatal. Symptoms associated with bacterial meningitis can include severe headache, neck
stiffness, high fever, nausea, vomiting, pain or discomfort when looking at bright lights,
sleepiness, and confusion. Affected infants may be fussy, irritable, and feed poorly.
Various types of brain infections lead to many different symptoms, which can depend on the
age of the person, the type of bacteria, the type of infection, and the acuteness of the disease.
In general, people older than 2 years of age with acute bacterial infection develop
high fever, severe headache, stiff neck, nausea, vomiting, discomfort when looking
into a bright light, sleepiness, and confusion.
Newborns and infants can be unusually fussy, irritable, and sleepy. They may feed
poorly and not be comforted by holding. Seizures can be a late development of the
disease.
Severe forms of bacterial meningitis, particularly meningococcal, can
cause shock with complete loss of consciousness and coma and bring about a
spreading purplish rash. An infant can have bulging fontanelles (soft spots) on the
head and have a decreased muscle tone in arms and legs.
Someone with viral brain infections tends to appear somewhat less ill. Flu-like
symptoms in addition to mild signs and symptoms outlined for each condition may be
seen.
Brain Infection Causes
Causes of bacterial meningitis: Three types of bacteria are the most common causes of
meningitis in all age groups except newborns:
How organisms are transmitted: Unlike the flu or the common cold, which can be
transmitted by casual contact or by simply breathing the air in the same room with an
infected person, most of the bacteria causing meningitis are not very contagious. It
would take the exchange of respiratory and throat secretions, from coughing,
sneezing, or kissing, to spread the bacteria. The only exception is meningococcal
meningitis. Anyone in the same household, or who had a prolonged contact, or was in
direct contact with a person's oral secretions would be considered at increased risk of
contracting the infection. People who have been exposed in this manner should
receive preventive antibiotics.
Those most at risk: Anyone can get bacterial meningitis. It most commonly affects
infants and small children. Anyone who had close or prolonged contact with a person
affected by certain bacteria (such as N. meningitidis or Hib) are also at increased risk.
This includes day-care workers, military recruits, jail cellmates, and anyone directly
exposed to discharges from the mouth or nose of an infected person. The other groups
at risk include people with weakened immune systems, diabetics, chronic alcoholics,
IV drug abusers, and anyone older than 60 years of age.
The following are other common brain infections:
o Toxoplasmosis (also known as toxo) is caused by the parasite Toxoplasma
gondii. Infection is acquired, for example, from an infected mother to an
unborn baby, by eating unwashed vegetables or undercooked meat, or by
direct contact with cat feces (the cat is a host for this organism). The
symptoms are similar to a mild form of bacterial meningitis. People at risk
are pregnant women and those with weakened immune systems, such as
people who are HIV positive. Prognosis is poor for infections transmitted from
mother to newborn. More than 50% of affected infants die within a few weeks
after birth. The disease also is severe in someone with a weakened immune
system, and aggressive treatment with medications is used. Frequently, death
results.
o Cerebral cysticercosis is caused by the pork tapeworm. The infestation is
acquired when people eat food contaminated by feces containing tapeworm
eggs. This disease has recently become relatively common in the southwestern
U.S. Depending on the stage of the disease, symptoms could be those of a
mild form of meningitis, or more severe form, or even cause sudden death.
The most common symptoms are seizures. Few medications can stop the
progression of the disease. However, once the cerebral form is acquired,
treatment is usually given to relieve the symptoms.
o Trichinosis is caused by the roundworm Trichinella spiralis. It is acquired by
eating larvae in raw or undercooked pork and some other wild meats,
including bear, moose, and wild boar. An infected person may have symptoms
similar to encephalitis with confusion and delirium. Coma, seizures, paralysis,
and other signs of neurologic loss are found in more severe forms. Most
people recover within a few days or weeks without any long-term problems.
The treatment is usually directed at symptom relief.
o One of the most common infections transmitted by insects in the U.S. is Lyme
disease. It is caused by the bacterium Borrelia burgdorferi, which infects and
multiplies inside of ticks of the Ixodes species. Then it is transmitted to
humans by the tick bite. If remained untreated, the disease can have serious
complications, which include various neurologic problems. The most common
neurologic complication is facial seventh nerve palsy (Bell's palsy, presenting
as a facial droop) or damage to other facial nerves, and inflammatory
radiculopathy (compression of nerve roots in the spine), which appears as
tingling, burning pain, or numbness in an extremity. Although rare, the most
concerning neurologic complication of late Lyme disease is meningitis, with
its typical symptoms and signs. A small percentage of the patients with
untreated Lyme disease and neurologic complications developed short-term
memory problems and other cognitive deficits. Early treatment with antibiotics
is advised when Lyme disease is suspected.
o Coccidioidal meningitis is a severe complication of coccidiomycosis (valley
fever), a common fungal infection in the southwestern U.S. The primary
disease is caused by the inhalation of the Coccidioides soil fungal spores,
leading to predominantly respiratory symptoms. Once the infection spreads to
other organs via the bloodstream, almost half of those affected develop
meningitis. The meningitis, in addition to the typical signs and symptoms, is
most commonly complicated by the presence of a hydrocephalus, which is the
abnormal accumulation of cerebrospinal fluid (CSF, fluid that bathes the brain
and spinal cord) in the ventricles of the brain. Additionally, the inflammatory
changes of the brain and its great vessels could cause symptoms similar to
those of a stroke. The treatment of this condition is very complex, with both
intravenous antifungal therapy and occasional direct infusion of the
medication in fluids bathing the brain and spinal cords. The hydrocephalus
frequently requires the placement of a ventriculoperitoneal shunt (which
drains the extra CSF directly from the brain ventricles into the abdominal
cavity). Despite all the technological and pharmacological developments in
recent years, the prognosis for this condition remains poor.
o An uncommon causative agent of meningitis, affecting almost exclusively
immunocompromised people, is a fungus from the Cryptococcus family. This
ubiquitous fungus thrives in soil and in the debris around tree bases, with a
particular predilection for bird droppings. The usual mode of transmission is
the inhalation of the fungal spores in soil, with subsequent spread through the
bloodstream to the CNS. Cryptococcal CNS infection causes the typical
symptoms and signs of meningitis. If left untreated, the patient has severe
complications with permanent brain damage, hearing loss, and coma. In
patients with severe immunodeficiency, the untreated disease is invariably
fatal. The usual treatment is in-hospital long-term infusion of intravenous
antifungal drugs. All people at risk should avoid bird droppings and any
outside activities, including digging and working with soil.
o Tuberculosis, caused by Mycobacterium tuberculosis, can spread through the
lymphatic system to the CNS. The resulting meningitis, has a short initial
period with symptoms of upper respiratory infection, followed by the onset of
various neurologic deficits, such as visual impairment, focal weakness and
numbness, and unstable gait with paralysis. The treatment is the same as for
tuberculosis, with a multidrug regimen and symptomatic management in a
hospital. Some studies suggested that BCG vaccination offers significant
protection against tuberculous meningitis and should be strongly considered in
people with high risk of contracting this disease.
o Cerebral abscess is often a complication of chronic sinus or middle-ear
infections or the distant spread of the infection from somewhere else (such as
a lung abscess or pneumonia). It can also be a consequence of head trauma or
a neurosurgical procedure. The symptoms depend on the location of the
abscess, but almost all people with this condition have a severe headache,
fever, or generalized malaise. Treatment includes IV antibiotics and frequently
surgical drainage.