Clinicoetiological Correlation of CNS Infections with Neuroimaging

Abstract

Introduction: CNS infections are life threatening condition which is limited to meninges or brain parenchyma. It could be bacterial, viral, fungal and parasitic. Diagnosis of CNS infection in children with specific pathogen has the utmost importance. Diagnosis is difficult in these patients due to nonspecific clinical feature. When patient with CNS infection admitted, it is hard to distinguish pyogenic and tubercular meningitis. Outcome in these patients depends upon stage of disease, time of diagnosis and proper treatment. Neuroimaging has a very crucial role in visualization of typical lesion in brain and spinal cord. This study planned to correlate clinical and etiological finding of CNS infection with neuroimaging. Method: This was a prospective observational study carried out in department of paediatrics in SBKS MIRC. All the confirmed cases of CNS infection in children (1 month to 18 years) were subjected to complete neuroimaging study, CT scan (with or without contrast) or MRI Scan. Result: 61 patients included in study, in which 26.2% with pyogenic infection, 42.6% with tubercular infection, 26.2% viral infection and 4.9% with parasitic infections were found. Total 75% in pyogenic group, 96.2% in tubercular group, 37.2% in viral group respectively had abnormal neuroimaging finding. Conclusion: Neuroimaging plays very important role in diagnosis of CNS infection specially tubercular and pyogenic. Although, CSF examination remains the gold standard investigation.