CNS Infection in Immunocompromised

Meningitis

·         Neck stiffness often absent

·         May not have raised WCC in CSF (especially if neutropaenic)

Brain abscess

·         High incidence in cancer patients (up to 25% of CNS infection)

·         Often present with nausea/vomiting and altered mental state.  Focal often (but not always) present.

·         If Neutrophil defects

o   Aspergillus

o   Mucormycosis

o   Candida

·         T-cell defects

o   Nocardia

o   Toxoplasma

Encephalitis

·         Associated with decreased cell-mediated immunity

·         Aetiology

o   VZV, HSV, CMV, Adenovirus

o   JC virus

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