Clinical characteristics, diagnostics, and outcome in central nervous system infections

The objective of my PhD was to analyse and describe patients suspected of CNS infections and assess the diagnostic accuracy of different methods for diagnosing CNS infections.
Chapter 2 investigated clinical features, prognostic factors, and serotypes of pneumococcal meningitis, and chapter 3 describes cases of recurrent bacterial meningitis. In chapter 4, we evaluated the association of bacterial meningitis and identified CSF leak and provide guidance when a CSF leak is suspected.
Diagnosing CNS infection can be difficult, as other neurological infections and non-neurological diseases may present with similar clinical characteristics. In chapter 5, we derive and validate a new risk score to differentiate patients with bacterial meningitis with patients with viral meningitis or encephalitis amongst those with leucocytosis and a negative gram staining result.
To improve outcome in this patient population, it is essential to recognize high-risk categories for unfavourable outcome. In chapter 6, we describe the clinical characteristics in adults with suspected CNS infections and determine predictors for unfavourable outcome to enhance diagnostics and treatments. Chapter 7, aims to identify the diagnostic accuracy of clinical and laboratory characteristics for diagnosing CNS infections in patients who present with a seizure.
In Chapter 8, we assess the diagnostic accuracy of neurofilament light chain in CSF as biomarker for diagnosing CNS infections. Chapter 9 investigates the diagnostic yield of comprehensive diagnostic testing for anti-neuronal antibodies in episodes primarily suspicious of an (acute) CNS infection or inflammation, where no obvious infectious, inflammatory, or alternative cause was found during hospitalization.