CNS Infections

In this episode of Critical Matters, Dr. Sergio Zanotti interviews Dr. Catherine Albin, a neurointensivist, about CNS infections, focusing on the management of meningitis and encephalitis in the ICU. Dr. Albin emphasizes the importance of considering CNS infections in encephalopathic ICU patients due to their high morbidity and mortality, discussing the incidence, definitions, and etiologies of meningitis and encephalitis, differentiating between acute and chronic presentations, and highlighting key pathogens like pneumococcus, meningococcus, and HSV. The conversation covers clinical presentations, diagnostic evaluations including lumbar punctures and imaging, and time-sensitive treatment approaches, stressing the need for early empiric therapy with antibiotics, steroids, and acyclovir. Dr. Albin also shares insights on ICU management, the significance of CSF diversion, and the importance of bedside neurological exams, concluding with personal recommendations on sleep and resources for clinicians.