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Infectious causes of stroke

Jillella, Dinesh V.; Wisco, Dolora R.

Current Opinion in Infectious Diseases: June 2019 - Volume 32 - Issue 3 - p 285–292
doi: 10.1097/QCO.0000000000000547
CNS INFECTIONS: Edited by Adarsh Bhimraj
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Purpose of review Stroke continues to be a leading cause of debility in the world. Infections have been associated with stroke, but are not considered as directly causal, and so they are not often included in the traditional stroke workup and management. They are especially important in patients with stroke of undetermined etiology, and in certain patient populations, such as young patients without traditional risk factors and immunocompromised patients.

Recent findings There has been strong evidence for infectious conditions, such as endocarditis, and pathogens, such as varicella zoster in stroke causation, and more supportive evidence is surfacing in recent years of several organisms increasing the stroke risk or being directly causal in stroke. The evidence also seems to be pointing to the role of inflammation in increasing the risk of stroke via accelerated atherosclerosis, vasculitis and vasculopathy.

Summary Infectious causes should be considered in the differential and work up of stroke in certain patient populations and appropriate treatments need to be initiated to minimize adverse stroke-related outcomes.

Cerebrovascular Center, Cleveland Clinic, Cleveland, Ohio, USA

Correspondence to Dolora R. Wisco, MD, Cerebrovascular Center, Cleveland Clinic, S80 Mail Code, 9500 Euclid Avenue, Cleveland, OH 44195, USA. Tel: +1 216 442 5639; fax: +1 216 636 2061; e-mail: wiscod@ccf.org

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