Journal Mobile

JN Day, JJ Farrar
Journal Issue: 
Volume 36: Issue 4: 2006




Neurological infections are a significant cause of morbidity and mortality worldwide. Increasing travel to exotic destinations and the rising HIV prevalence are resulting in increasing incidences of previously rare diseases. Timely treatment is key in determining a successful outcome. This depends upon taking a meticulous history that details the timing and presence of risks and exposures, which, with knowledge of  incubation  periods,  enables  generation  of  a  differential  diagnosis  leading  to focused  investigations.   Recent  trials  have  generated  good  evidence  to  improve outcome in important infections: for example, artesunate has been shown to be the best drug to use in severe malaria, and the value of adjunctive steroids in pyogenic bacterial and TBM has been clearly demonstrated.  However, evidence is lacking on the best treatment for other infections. The rising incidence of syphilis in the UK in the  last  few  years  has  posed  difficult  questions  regarding  antibiotic  choices, since good clinical data do not exist; randomised controlled trials are urgently needed.  In HIV, the advent of HAART has reduced the incidence of opportunistic infections in those fortunate enough to receive it.  However, central nervous system infections continue  to  account  for  considerable  morbidity  and  mortality  in  these  patients around the world and in patients presenting with AIDS in the UK.