Neuroinfectious Disease in Isolation

STEVEN L. LEWIS, MD, FAAN Neuroinfectious Disease p. 1262-1263 October 2018, Vol.24, No.5 doi: 10.1212/01.CON.0000546585.48959.5a
Editor’s Preface


The main goals of every issue of Continuum are to provide our readers with a state-of-the-art, comprehensive, and current review of a particular category of disorders so that they can remain up-to-date in the diagnosis and management of those disorders and to be a one-stop shop for neurologists to find the information they need about these conditions whenever and wherever they need it. In this issue, Guest Editor Joseph R. Zunt, MD, MPH, along with his team of experts, has succeeded in these goals, providing us with a compendium devoted to neuroinfectious disease that will greatly assist all of us in our diagnosis and management of patients with infections affecting the nervous system.

The issue begins with a very practical article by Dr Larry E. Davis on the diagnosis of acute bacterial meningitis throughout the lifespan. Dr Jennifer L. Lyons then discusses many of the various causes and presentations of viral meningitis and encephalitis, excluding herpes encephalitis, which is covered in a later article in the issue. The diagnosis and contemporary management of more chronic causes of meningitis, including infectious and noninfectious etiologies, are reviewed by Drs Kiran T. Thakur and Michael R. Wilson.

Dr Felicia Chow discusses the diagnosis and management of brain abscesses and spinal epidural abscesses, disorders that can lead to devastating outcomes if not diagnosed and managed expeditiously (like most of the other treatable infectious conditions discussed in this issue) and that require interdisciplinary cooperation and communication, especially with our neurosurgical colleagues. Drs Kelly J. Baldwin and Christopher L. Cummings discuss the variety of disorders of the nervous system caused by the herpesviruses.

Moving on to the immunocompromised host, Dr Amy A. Pruitt reviews the diagnosis and treatment of the spectrum of central nervous system infections that may complicate immunosuppression and transplantation. Dr Deanna Saylor then provides an up-to-date review of the diagnosis and management of many neurologic complications of human immunodeficiency virus (HIV) infection.

Guest Editor Dr Joseph R. Zunt discusses the current diagnosis and management strategies for tuberculosis of the central nervous system, a disorder that remains quite relevant in both underdeveloped and developed countries. Dr John J. Halperin then reviews the diagnosis and management of neuroborreliosis and neurosyphilis, carefully delineating the similarities and differences between these two important spirochetal infections of the nervous system.

Dr Aaron L. Berkowitz tackles the diagnosis and management of tetanus, botulism, and diphtheria, bacterial disorders that share the similarities of being gram-positive rods and of each producing their unique neurologic syndrome through the production of a neurotoxin. Dr Tracey A. Cho then discusses helminthic infectious of the central nervous system, in particular neurocysticercosis and neuroschistosomiasis, parasitic diseases that need to be on all neurologists’ radar no matter where in the world they practice. In the final review article, Dr James J. Sejvar gives us an overview of the recent and evolving history of Zika virus (the virus depicted on the cover of this issue), its effects on the developing nervous system, and its association with Guillain-Barré syndome in adults and reviews other emerging arboviral infections of the central nervous system.

In the Ethical and Medicolegal Issues article, Ms Rachel V. Rose and Dr Joseph S. Kass dissect a hypothetical case history to review the legal and ethical considerations of disclosing HIV seropositivity to a surrogate decision maker.

After reading the issue and taking the Postreading Self-Assessment and CME Test written by Drs Douglas J. Gelb and Allyson R. Zazulia, you may earn up to 20 AMA PRA Category 1 CreditsTM toward self-assessment and CME or, for Canadian participants, a maximum of 20 hours toward the Self-Assessment Program (Section 3) of the Maintenance of Certification Program of the Royal College of Physicians and Surgeons of Canada. Additional credit can be obtained by listening to Continuum Audio interviews associated with this and other Continuum issues, available to all subscribers, and completing tests on the Continuum Audio web platform or app. Continuum Audio is also accredited by the Royal College of Physicians and Surgeons of Canada.

Finally, a reminder to our readers to check out our more user-friendly website at, with easier search features to find the information you need and quick access to Continuum Audio interviews with our authors. We continue to appreciate any comments on the evolving website, which can be sent to [email protected].

My deep thanks to Dr Zunt and all the expert contributors to this issue for “spreading the word” on neuroinfectious disease to inform us about clinical features and current diagnostic and management options for these disorders, which, in so many cases, have specific and effective therapies that can be wielded by the neurologist to avoid neurologic morbidity and mortality.


© 2018 American Academy of Neurology.