Critical care management of meningitis and encephalitis: an update.
Journal
Current opinion in critical care
ISSN: 1531-7072
Titre abrégé: Curr Opin Crit Care
Pays: United States
ID NLM: 9504454
Informations de publication
Date de publication:
01 10 2022
01 10 2022
Historique:
pubmed:
18
8
2022
medline:
9
9
2022
entrez:
17
8
2022
Statut:
ppublish
Résumé
Meningitis and encephalitis represent severe neurological syndromes associated with encephalopathy, seizures, focal deficits, and neurological sequelae in survivors. We update on the critical care management of adult patients with severe meningitis and encephalitis. Large multicenter studies conducted in the adult population improved current knowledge on the epidemiology and outcomes of patients with severe meningitis and encephalitis. An early multimodal diagnostic workup (including CSF analysis, brain MRI, EEG, and serum studies) is mandatory for diagnosis and prognostication in those patients.New diagnostic methods, including multiplex PCR and next-generation sequencing techniques, allow for a faster differential diagnosis of infectious causes that may require specific antimicrobial therapy. Autoimmune causes of encephalitis, which may require urgent immunotherapy, are also increasingly recognized in the ICU setting. Although observational data suggest that early combined immunotherapy is associated with better neurological outcomes in patients with autoimmune encephalitis, randomized clinical trials have yet to be performed. Our review highlights the importance of an early multimodal approach for diagnosing severe meningitis and encephalitis. Randomized clinical trials are needed to identify pharmacological interventions that may improve patients' outcomes.
Identifiants
pubmed: 35975963
doi: 10.1097/MCC.0000000000000980
pii: 00075198-202210000-00006
doi:
Types de publication
Journal Article
Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
486-494Informations de copyright
Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.
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