Chapter 39. Nervous System Infections and Catheter Infections

George H Karam, MD, FCCP
DOI: 10.1378/critcare.21.39
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  • Review clinical presentations of nervous system infections that may present as serious or life-threatening processes.

  • Outline principles influencing diagnosis and management of nervous system infections.

  • Present an approach to infections related to catheters placed in the vasculature, urinary bladder, or peritoneum.

  • Summarize existing opinions and data about management of catheter-related infections.


Infection affecting various parts of the nervous system has the potential to be life-threatening or to result in severe sequelae if the infection is not appropriately diagnosed and treated. Although infections such as meningitis, encephalitis, and brain abscess are the most frequently encountered, processes such as spinal epidural abscess, septic intracranial thrombophlebitis, rabies, and botulism may present as emergent problems that require a high level of clinical suspicion for prompt diagnoses to be made. Infections associated with catheters placed in the vasculature, urinary bladder, or peritoneum can also result in morbidity and create diagnostic or therapeutic dilemmas for the clinician. This review will attempt to summarize these infections as they relate to the critical care setting.


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