Neuroinfectious Disease, Part 2

Anna M. Cervantes-Arslanian, MD

Neurologists' knowledge and understanding of infectious disease is an ever-growing necessity in the modern world. The impact of increasing globalization and expansion into previously undeveloped areas has led to the emergence of several viruses with a predilection for CNS involvement. Furthermore, many illnesses that were virtually eradicated in upper- and middle-income nations are making a comeback due to voluntary refusal of immunization programs (e.g., measles) and the persistence of illnesses in developing nations (e.g., polio and tuberculosis). Other pathogens are still poorly understood and almost purely manifest as neurologic illness (e.g., prions). Accordingly, there has been growing interest of neurologists in the subspecialty of neuroinfectious disease. This issue is the second of a two-part series in Seminars in Neurology dedicated to the practical aspects of diagnosis and management of infectious diseases of the nervous system. The articles are written by a distinguished group of international neurologists with expertise in infectious disease, together with specialists from many other disciplines (infectious disease, internal medicine, cardiology, neurosurgery, radiology, and cardiac surgery). We hope the articles are useful to neurologists and nonneurologists alike.

In this volume, we begin by covering new and emerging illnesses such as arboviruses (Gill et al), prion diseases (Baldwin and Correll), and tick-borne illness (Halperin). The articles that follow cover diseases known since antiquity: syphilis (Gonzalez et al), tuberculosis (Chin), and Leprosy (Lau). Next Asundi et al, review infections affecting the spinal cord. The final articles may be of particular interest to the practice of vascular neurology and neurocritical care, with Shulman and Cervantes-Arslanian reviewing infectious etiologies of stroke, Carneiro et al reviewing the neurologic complications of endocarditis with a specific focus on surgical considerations, and Sader et al discussing neurosurgical infections.

The goal of these issues is to provide a comprehensive review of the current diagnosis, treatment, and management of infectious diseases of the nervous system. We hope that we have reaffirmed the importance of neurologists in the management of infectious disease, and perhaps piqued the interest of trainees who may be considering this subspecialty. Neurologic infectious diseases affect every subspecialty of neurology, causing cerebrovascular disease, epilepsy, movement disorders, and dementia. To steal from the words of Osler, “to know syphilis is to know medicine,” I would like to propose the corollary that to know neuroinfectious disease is to know neurology. With this in mind, I am grateful to the authors for their spectacular work on this issue and to Dr. David Greer for honoring me with the invitation to guest edit. Dr. Greer's support for my career is the second only after David (my husband), our beautiful children (Isaac, Jacob, and Abigail), and our parents Carol, Francisco, Leslie, and Ronald, in my life.