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Review
. 2021 Feb;39(1):101-121.
doi: 10.1016/j.emc.2020.09.006. Epub 2020 Nov 5.

Central Nervous System Infections in the Immunocompromised Adult Presenting to the Emergency Department

Robert J Stephens  1 , Stephen Y Liang  2
Affiliations
Review

Central Nervous System Infections in the Immunocompromised Adult Presenting to the Emergency Department

Robert J Stephens et al. Emerg Med Clin North Am. 2021 Feb.

Abstract

Over the past 2 decades, the population of immunocompromised patients has increased dramatically in the United States. These patients are at elevated risk for both community-acquired and opportunistic central nervous system infections. We review the most common and serious central nervous system pathogens affecting these patients and outline a diagnostic and therapeutic approach to their management in the emergency department. We recommend a broad diagnostic evaluation, including neuroimaging and cerebrospinal fluid studies where appropriate, empiric antimicrobial therapy, and early involvement of subspecialists to provide comprehensive care for these complex patients.

Keywords: CNS infection; HIV; Immunocompromise; Meningitis; Transplant.

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Conflict of interest statement

Disclosure R.J. Stephens and S.Y. Liang have no conflicts of interest to disclose. S.Y. Liang received support through the Foundation for Barnes-Jewish Hospital and the Washington University Institute of Clinical and Translational Sciences which is, in part, supported by the NIH/National Center for Advancing Translational Sciences (NCATS), Clinical and Translational Science Award (CTSA) program (UL1TR002345).

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