CC BY-NC-ND 4.0 · Neurology International Open 2017; 01(04): E316-E325
DOI: 10.1055/s-0043-118924
New Developments in Neurology
Eigentümer und Copyright ©Georg Thieme Verlag KG 2017

Update Opportunistic Infections of the Central Nervous System in Patients with Iatrogenic Immunosuppression

Gabriele Arendt
Department of Neurology, University Hospital Düsseldorf, Düsseldorf, Germany
,
Matthias Maschke
Department of Neurology, Barmherzige Brüder Hospital, Trier, Germany
› Author Affiliations
Further Information

Publication History

Publication Date:
22 November 2017 (online)

Abstract

Opportunistic infections of the central nervous system (CNS) with bacteria, parasites, fungi or viruses due to iatrogenic immunosuppression are of immense importance because of rising numbers of organ transplantations and immunomodulating treatments. Besides transplantation medicine, the most frequently involved medical subspecialties are dermatology (interferons, rituximab, fingolimod, among others), hematology/oncology (rituximab, among others), neurology (beta-interferon, glatiramer acetate, natalizumab, rituximab, teriflunomide, fingolimod, alemtuzumab, daclizumab, among others) and rheumatology (rituximab).

In Europe, typical infections affecting the immunocompromised host are due to herpes viruses and, especially in immunomodulated patients, JC virus (JCV); frequently occurring fungi are Aspergillus fumigatus, Candida albicans and Cryptococcus neoformans. An important parasite is Toxoplasma gondii (TG). Typical bacterial infections of the immunocompromised patient are caused by Nocardia asteroides, Listeria monocytogenes and Mycobacterium tuberculosis.Modern diagnostic and therapeutic procedures will be described.