Anthrax Meningoencephalitis and Intracranial Hemorrhage
Abstract
The neurological sequelae of Bacillus anthracis infection include a rapidly progressive fulminant meningoencephalitis frequently associated with intracranial hemorrhage, including subarachnoid and intracerebral hemorrhage. Higher mortality than other forms of bacterial meningitis suggests that antimicrobials and cardiopulmonary support alone may be insufficient and that strategies targeting the hemorrhage might improve outcomes. In this review, we describe the toxic role of intracranial hemorrhage in anthrax meningoencephalitis. We first examine the high incidence of intracranial hemorrhage in patients with anthrax meningoencephalitis. We then review common diseases that present with intracranial hemorrhage, including aneurysmal subarachnoid hemorrhage and spontaneous intracerebral hemorrhage, postulating applicability of established and potential neurointensive treatments to the multimodal management of hemorrhagic anthrax meningoencephalitis. Finally, we examine the therapeutic potential of minocycline, an antimicrobial that is effective against B. anthracis and that has been shown in preclinical studies to have neuroprotective properties, which thus might be repurposed for this historically fatal disease.
Document Details
- Document Type
- Pub Defense Publication
- Publication Date
- Oct 15, 2022
- Source ID
- 10.1093/cid/ciac521
Entities
People
- J Marc Simard
- John S. Bradley
- Katherine Hendricks
- Nancy A. Twenhafel
- Nicholas Caffes
Organizations
- Centers for Disease Control and Prevention
- National Heart, Lung, and Blood Institute
- National Institute of Neurological Disorders and Stroke
- National Institutes of Health
- United States Department of Defense
- United States Department of Veterans Affairs
- University of California
- University of Maryland School of Medicine