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Meningitis and encephalitis management in the ICU

Robinson, Christopher P.; Busl, Katharina M.

Current Opinion in Critical Care: October 2019 - Volume 25 - Issue 5 - p 423–429
doi: 10.1097/MCC.0000000000000640
SEVERE INFECTIONS: Edited by Michael S. Niederman

Purpose of review Management of patients with meningitis and encephalitis oftentimes requires ICU level of care. This article is an update on management for meningitis and encephalitis with focus on clinical care in the ICU. Information provided is based on a review of recent studies with focus on studies since 2017.

Recent findings Advances in diagnostic and treatment approach for different pathogens are presented. Nosocomial meningitis now constitutes a major part of brain infections seen in ICUs in the developed world. Advances in ICU care of central nervous system (CNS) infections include application of newer diagnostic methods, improved understanding and delivery of antibiotics to the CNS, infection prevention for nosocomial infections, and application of neuromonitoring where indicated.

Summary Advances in diagnostics and therapeutic approach to CNS infections are continually made. For intensivists, focus on neuromonitoring and brain resuscitation in critically ill patients with CNS infections may present a path to enhance preservation of brain function and improve outcomes.

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Division of Neurocritical Care, Department of Neurology, University of Florida College of Medicine, Gainesville, Florida, USA

Correspondence to Katharina M. Busl, MD, MS, Division of Neurocritical Care, Department of Neurology, University of Florida College of Medicine, McKnight Brain Institute L3-100, 1149 Newell Drive, Gainesville, FL 32610, USA. Tel: +1 352 273 5067; e-mail:

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