Central Nervous System Infections in Denmark

Inclusion Criteria33

• Definitions of central nervous system infections:
• For all cases with unproven aetiologies no alternative diagnosis than CNS infection is thought more likely after completed multidisciplinary diagnostic work-up.
• \- All patients have to have a clinical presentation consistent with non-bacterial meningitis (e.g. headache, neck stiffness, photo- or phonophobia, fever)
• and
• Cerebrospinal fluid leukocytes\>10 cells/ml
• Patients with viral meningitis with undetermined pathogen have to have:
• CSF leukocytes\> 10/mL and no other more probable diagnosis assessed by the local investigator.
• In case of doubt, patients are discussed with the DASGIB secretary and chair or at meetings.
• and
• Proven bacterial aetiology (CSF or blood culture/DNA based technology or antigen tests)
• Patients with bacterial meningitis in whom the bacteria cannot not be cultured or identified by DNA-based technologies have to have:
• \- CSF leukocytes\> 10/mL and no other more probable diagnosis assessed by the local investigator.
• In case of doubt, patients are discussed with the DASGIB secretary and chair or at meetings.
• \- All patient have a clinical presentation consistent with brain abscess (e.g. headache, focal neurological deficit, mass lesion on cranial imaging)
• and
• \- Proven microbiological aetiology by culture/DNA-based technology from pus from brain abscess or blood or CSF
• or
• \- Aspiration of pus from the brain abscess
• or
• \- Response to antimicrobial treatment
• or
• \- Tumour ruled out
• or
• \- Tumour thought less probable than abscess on MRI using diffusion weighted imaging (DWI) and apparent diffusion coefficient (ADC) sequences.
• \- A clinical presentation consistent with neuroborreliosis (e.g. radiculopathy)
• and
• \- CSF pleocytosis\>10 leukocytes/mL
• and
• \- Positive intrathecal B.burgdorferi antibody production index.
• and either
• \- Positive syphilis serology in serum combined with CSF leukocytes\>10/mL
• or
• \- CSF syphilis antibodies.