Management of Viral Central Nervous System Infections: A Primer for Clinicians

Author(s)

P Brandon Bookstaver, University of South Carolina - ColumbiaFollow
Phillip L. Mohorn, Department of Pharmacy, Spartanburg Medical Center, Spartanburg Regional Healthcare System
Ansal Shah, Division of Infectious Diseases, School of Medicine, University of South Carolina
Lauren D. Tesh, Division of Advisory Committee and Consultant Management, Office of Executive Programs, Center for Drug Evaluation and Research, Food and Drug Administration
April M. Quidley, Department of Pharmacy Services, Vidant Medical Center
Ravish Kothari, Department of Neurology, University of South Carolina/Palmetto Medical Group, Columbia, SC, USA.
Christopher M. Bland, Department of Clinical and Administrative Pharmacy, University of Georgia College of Pharmacy
Sharon Weissman, Division of Infectious Diseases, Department of Internal Medicine, School of Medicine, University of South Carolina

Document Type

Article

Abstract

Viruses are a common cause of central nervous system (CNS) infections with many host, agent, and environmental factors influencing the expression of viral diseases. Viruses can be responsible for CNS disease through a variety of mechanisms including direct infection and replication within the CNS resulting in encephalitis, infection limited to the meninges, or immune-related processes such as acute disseminated encephalomyelitis. Common pathogens including herpes simplex virus, varicella zoster, and enterovirus are responsible for the greatest number of cases in immunocompetent hosts. Other herpes viruses (eg, cytomegalovirus, John Cunningham virus) are more common in immunocompromised hosts. Arboviruses such as Japanese encephalitis virus and Zika virus are important pathogens globally, but the prevalence varies significantly by geographic region and often season. Early diagnosis from radiographic evidence and molecular (eg, rapid) diagnostics is important for targeted therapy. Antivirals may be used effectively against some pathogens, although several viruses have no effective treatment. This article provides a review of epidemiology, diagnostics, and management of common viral pathogens in CNS disease.

Digital Object Identifier (DOI)

https://doi.org/10.1177/1179573517703342

Publication Info

Published in Journal of Central Nervous System Disease, Volume 9, 2017, pages 1179573517703342-.

Rights

Creative Commons Non Commercial CC BY-NC: This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 3.0 License (http://www.creativecommons.org/licenses/by-nc/3.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage).

CC BY-NC 3.0; © The Author(s) 2017

APA Citation

Bookstaver, P. B., Mohorn, P. L., Shah, A., Tesh, L. D., Quidley, A. M., Kothari, R., Bland, C. M., & Weissman, S. (2017). Management of Viral Central Nervous System infections: A Primer for clinicians. Journal of Central Nervous System Disease, 9, 117957351770334. https://doi.org/10.1177/1179573517703342