ArticleWiener medizinische Wochenschrift (1946)2025
Cerebral vasculitis as a severe complication of acute infectious meningoencephalitis-a case series of five different pathogens.
Article in Wiener medizinische Wochenschrift (1946), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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1 citing paper in PubMed.
- PurulentRadiology case reports · 2026Article
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7 authors.
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Abstract
backgroundAcute infectious meningoencephalitis is a severe condition caused by bacterial, viral, fungal, or parasitic infections of the central nervous system (CNS). A rare but severe complication is cerebral vasculitis with ischemic infarcts. The available literature is sparse and mainly restricted to case reports, further challenging an accurate and timely diagnosis.
methodsWe provide a detailed retrospective analysis of five cases of fulminant infectious vasculitis accompanied by ischemic strokes treated at the neurological intensive care unit (ICU) of the Department of Neurology, Medical University of Graz, Austria, from 2017 to 2023 to determine risk factors and possible treatment options.
resultsWe report one case each of CNS vasculitis associated with an infection with Streptococcus pneumoniae, varicella zoster virus (VZV), human herpesvirus 6 (HHV-6), Borrelia burgdorferi, and Cryptococcus neoformans, each resulting in devastating disseminated ischemic infarcts. The described patients were between 49 and 73 years old, with a male to female ratio of 3:2. The final diagnosis was unfortunately delayed in all cases, ranging from 6-60 days after symptom onset. The outcome was fatal in four of the cases.
conclusionInfectious cerebral vasculitis can occur irrespective of the causative agent's nature. Known typical risk factors are an immunocompromised state of the patient; delayed diagnosis and treatment; and the presence of age-related vascular changes, although this complication can also occur completely unexpectedly. Infarcts may even occur in the weeks following the infection. In case of an infection with Streptococcus pneumoniae, also the possibility of antibiotic resistance must increasingly be kept in mind. To our knowledge, we are the first to report fatal HHV‑6 encephalitis and vasculitis in a previously healthy 49-year-old male treated with oral steroids for alopecia areata without any history of solid organ or stem cell transplantation.
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