Advances in the Diagnosis and Treatment of Infections of the Central Nervous System

A special issue of Diagnostics (ISSN 2075-4418). This special issue belongs to the section "Clinical Diagnosis and Prognosis".

Deadline for manuscript submissions: closed (30 November 2025) | Viewed by 23801

Special Issue Editors


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Guest Editor
Department of Radiology, CTO Hospital, Azienda Ospedaliera dei Colli, Viale Colli Aminei 21, 80141 Naples, Italy
Interests: neuroradiology; head and neck imaging; pediatric neuroradiology; artificial intelligence

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Guest Editor
Department of Radiology, CTO Hospital, Azienda Ospedaliera dei Colli, Viale Colli Aminei 21, 80141 Naples, Italy
Interests: neuroradiology

Special Issue Information

Dear Colleagues,

Central nervous system (CNS) infections are common and serious diseases that are generally treated in secondary and tertiary centers. The diagnosis and treatment of these diseases are complicated and extremely variable, depending on multiple factors. Laboratory and neuroimaging play a crucial role in this setting. Imaging findings are variable, and thus differential diagnosis can be complicated. Furthermore, in patients with recurrent CNS infections, it is important to look for predisposing elements; thus, special expertise is required to detect them. In recent years, there have been crucial improvements in the management of CNS infections, especially owing to the introduction of novel magnetic resonance imaging techniques and laboratory tests.

This Special Issue will focus on recent advances in the diagnosis and treatment of CNS infections.

Dr. Teresa Perillo
Dr. Raffaella Capasso
Guest Editors

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Keywords

  • central nervous system infections
  • meningitis
  • HIV
  • tuberculosis
  • magnetic resonance imaging

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Published Papers (2 papers)

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Research

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12 pages, 375 KB  
Article
Exploring the Role of Cerebrospinal Fluid and Serum Mid-Regional Pro-Adrenomedullin in Tick-Borne Encephalitis: A Pilot Study
by Gabriela Trojan, Anna Moniuszko-Malinowska, Joanna Oklińska, Wioletta Pawlak-Zalewska, Ewelina Kruszewska, Agnieszka Kulczyńska-Przybik, Barbara Mroczko and Piotr Czupryna
Diagnostics 2026, 16(1), 95; https://doi.org/10.3390/diagnostics16010095 (registering DOI) - 27 Dec 2025
Abstract
Background: Adrenomedullin (ADM) is a multifunctional peptide with vasoregulatory, antimicrobial, and anti-inflammatory properties. Its stable fragment, mid-regional pro-adrenomedullin (MR-proADM), is a validated biomarker in sepsis and systemic infections, but its role in viral neuroinfections remains unexplored. Tick-borne encephalitis (TBE), caused by the [...] Read more.
Background: Adrenomedullin (ADM) is a multifunctional peptide with vasoregulatory, antimicrobial, and anti-inflammatory properties. Its stable fragment, mid-regional pro-adrenomedullin (MR-proADM), is a validated biomarker in sepsis and systemic infections, but its role in viral neuroinfections remains unexplored. Tick-borne encephalitis (TBE), caused by the tick-borne encephalitis virus (TBEV), is a major viral infection of the central nervous system (CNS) associated with long-term neurological sequelae. This study aimed to assess MR-proADM levels in cerebrospinal fluid (CSF) and serum of patients with TBE and to evaluate their diagnostic utility and pathophysiological significance. Methods: This retrospective observational study included 20 patients with confirmed TBE and 14 non-infectious neurological controls. MR-proADM concentrations were measured in paired CSF and serum samples using an ELISA assay. Statistical analyses included group comparisons (Mann–Whitney U test), correlation analyses (Spearman’s r), and receiver operating characteristic (ROC) curve evaluation. Results: Serum MR-proADM levels at baseline (SER1) were significantly lower in TBE patients compared with controls (p = 0.0197). The CSF/serum MR-proADM ratio differed significantly between groups (p = 0.0063) and showed the best diagnostic performance (AUC = 0.816, 95% CI 0.63–0.93; sensitivity 79%, specificity 80%). MR-proADM concentrations in CSF correlated with total CSF protein (r = 0.53), suggesting an association with blood–CSF barrier dysfunction. Strong reproducibility was observed for serum MR-proADM between sampling points (r = 0.83). Conclusions: MR-proADM levels in CSF and serum are altered in patients with TBE, indicating its potential as a biomarker of CNS infection and inflammation. The CSF/serum MR-proADM ratio may serve as a sensitive indicator of blood–CSF barrier involvement, while decreased serum levels may reflect impaired systemic neuroprotective response. These findings highlight a possible role of ADM in neuroimmune regulation during viral encephalitis and warrant validation in larger prospective studies. Full article
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Review

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20 pages, 58187 KB  
Review
Neuroimaging of the Most Common Meningitis and Encephalitis of Adults: A Narrative Review
by Teresa Perillo, Raffaella Capasso and Antonio Pinto
Diagnostics 2024, 14(11), 1064; https://doi.org/10.3390/diagnostics14111064 - 21 May 2024
Cited by 5 | Viewed by 23108
Abstract
Meningitis is the infection of the meninges, which are connective tissue membranes covering the brain, and it most commonly affects the leptomeninges. Clinically, meningitis may present with fever, neck stiffness, altered mental status, headache, vomiting, and neurological deficits. Encephalitis is an infection of [...] Read more.
Meningitis is the infection of the meninges, which are connective tissue membranes covering the brain, and it most commonly affects the leptomeninges. Clinically, meningitis may present with fever, neck stiffness, altered mental status, headache, vomiting, and neurological deficits. Encephalitis is an infection of the brain, which usually presents with fever, altered mental status, neurological deficits, and seizure. Meningitis and encephalitis are serious conditions which could also coexist, with high morbidity and mortality, thus requiring prompt diagnosis and treatment. Imaging plays an important role in the clinical management of these conditions, especially Magnetic Resonance Imaging. It is indicated to exclude mimics and evaluate the presence of complications. The aim of this review is to depict imaging findings of the most common meningitis and encephalitis. Full article
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