Revision 5 for 'Septic-embolic encephalitis'

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Septic-embolic encephalitis

Septic-embolic encephalitis, also referred as septic-embolic brain abscess, corresponds to a focal or diffuse brain infection, ischemic and hemorrhagic damages following an infective thromboembolism from any part of the body 1. It is usually caused by bacterial infections from endocarditis. 


Septic-embolic encephalitis must be differentiated from sepsis-associated encephalopathy, which is a clinical syndrome related to a diffuse brain dysfunction in the context of sepsis and without overt CNS infection.


In most series CNS involvement during the course of infective endocarditis occurs in 20% to 40% of cases 2

Clinical presentation

Symptoms can vary from headache to unconsciousness, the most common are 1,3:

  • fever
  • toxic encephalopathy: characterized by mental status changes and psychosis  
  • brain hemorrhage: as a result of vessels damage; rarely it can be a late complication due a mycotic aneurysm rupture 
  • meningism signs
  • headache
  • seizures
Risk factors:
  • cardiac disease:
    • rheumatic cardiovascular disease
    • mitral valve prolapse
    • prosthetic cardiac valves
    • congenital heart disease 
  • drug addiction (intravenous drugs)
  • immunocompromised patients 
  • central venous catheter 
  • arteriovenous shunts  



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