Infectious causes of peripheral nervous system (PNS) disease are underrecognized but potentially treatable. Heightened awareness educed by advanced understanding of the presentations and management of these infections can aid diagnosis and facilitate treatment. In this review, we discuss the clinical manifestations, diagnosis, and treatment of common bacterial, viral, and parasitic infections that affect the PNS. We additionally detail PNS side effects of some frequently used antimicrobial agents.
EstanislaoLHartPSimpsonD. HIV neuropathy and selected infectious neuropathies. Continuum. 2003;9(6):118–145.
2.
KranickSMNathA. Neurologic complications of HIV-1 infection and its treatment in the era of antiretroviral therapy. Contin Lifelong Learn Neurol. 2012;18(6):1319–1337.
LyonsJVennaNChoT. A typical nervous system manifestations of HIV. Semin Neurol. 2011;31(3):254–265.
5.
GoncalvesDUProiettiFARibasJGR. Epidemiology, treatment, and prevention of human T-cell leukemia virus type 1-associated diseases. Clin Microbiol Rev. 2010;23(3):577–589.
6.
AraujoAQSilvaMTT. The HTLV-1 neurological complex. Lancet Neurol. 2006;5(12):1068–1076.
EllieERozenbergFDoussetVBeylot-BarryM. Herpes simplex virus type 2 ascending myeloradiculitis: MRI findings and rapid diagnosis by the polymerase chain method. J Neurol Neurosurg Psychiatry. 1994;57(7):869–870.
16.
KrishnaADevulapallyPGhobrialI. Meningitis retention syndrome. J Community Hosp Intern Med Perspect. 2012;2(1):1–3.
17.
AureliusEForsgrenMGilleESkoldenbergB. Neurologic morbidity after herpes simplex type 2 meningitis: a retrospective study of 40 patients. Scand J Infect Dis. 2002;34:278–283.
18.
CresswellFEadieJLongleyNMacallanD. Severe Guillain–Barré syndrome following primary infection with varicella zoster virus in an adult. Int J Infect Dis. 2010;14(2):e161–e163.
19.
SolomonCGCohenJI. Herpes zoster. N Engl J Med. 2013;369(3):255–263.
20.
OrlikowskiDPorcherRSivadon-TardyV. Guillain-Barre syndrome following primary cytomegalovirus infection: a prospective cohort study. Clin Infect Dis. 2011;52(7):837–844.
21.
SoYTOlneyRK. Acute lumbosacral polyradiculopathy in acquired immunodeficiency syndrome: experience in 23 patients. Ann Neurol. 1994;35(1):53–58.
22.
BeharRWileyCMcCutchanJ. Cytomegalovirus polyradiculoneuropathy in acquired immune deficiency syndrome. Neurology. 1987;37(4):557–561.
23.
RoulletEAssuerusVGozlanJ. Cytomegalovirus multifocal neuropathy in AIDS analysis of 15 consecutive cases. Neurology. 1994;44(11):2174–2174.
24.
KimYHollanderH. Polyradiculopathy due to cytomegalovirus: report of two cases in which improvement occurred after prolonged therapy and review of the literature. Clin Infect Dis. 1993;17(1):32–37.
25.
DowlingPCCookSD. Role of infection in Guillain-Barré syndrome: laboratory confirmation of herpes viruses in 41 cases. Ann Neurol. 1981;9(suppl):44–55.
26.
MajidAGalettaSSweeneyC. Epstein-Barr virus myeloradiculitis and encephalomyeloradiculitis. Brain. 2002;125(pt 1):159–165.
27.
LindseyNPStaplesJELehmanJAFischerM. Surveillance for human west Nile virus disease—United States, 1999-2008. MMWR Surveill Summ. 2010;59(2):1–17.
28.
PetersenLR. West Nile virus: review of the literature. JAMA. 2013;310(3):308–315.
29.
BurtonJMKernRZHallidayW. Neurological manifestations of West Nile virus infection. Can J Neurol Sci. 2003;31(2):185–193.
30.
MonacoSFerrariSGajofattoAZanussoGMariottoS. HCV-related nervous system disorders. Clin Dev Immunol. 2012;2012:1–9.
31.
CacoubPSaadounDLimalNLegerJMMaisonobeT. Hep C virus infection and mixed cryoglobulinaemia vasculitis: a review of neurological complications. AIDS. 2005;19(suppl 3):S128–S134.
32.
MayoMJKaplanNMPalmerBF. Extrahepatic manifestations of hepatitis C infection. Am J Med Sci. 2003;325(3):135–148.
33.
NemniRSanvitoLQuattriniASantuccioGCamerlingoMCanalN. Peripheral neuropathy in hepatitis C virus infection with and without cryoglobulinaemia. J Neurol Neurosurg Psychiatry. 2003;74(9):1267–1271.
34.
BonettiBScardoniMMonacoSRizzutoNScarpaA. Hepatitis C virus infection of peripheral nerves in type II cryoglobulinaemia. Virchows Arch. 1999;434(6):533–535.
35.
BrianiCChemelloLZaraG. Peripheral neurotoxicity of pegylated interferon alpha: a prospective study in patients with HCV. Neurology. 2006;67(5):781–785.
HemachudhaTUgoliniGWacharapluesadeeSSungkaratWShuangshotiSLaothamatasJ. Human rabies: neuropathogenesis, diagnosis, and management. Lancet Neurol. 2013;12(5):498–513.
39.
WilloughbyREJrTievesKSHoffmanGM. Survival after treatment of rabies with induction of coma. N Engl J Med. 2005;352(24):2508–2514.
GerberMAShapiroEDBurkeGSParcellsVJBellGL. Lyme disease in children in southeastern Connecticut. N Engl J Med. 1996;335(17):1270–1274.
42.
SteereA. Lyme disease. N Engl J Med. 1989;321(9):586–596.
43.
HalperinJJ. Lyme disease and the peripheral nervous system. Muscle Nerve. 2003;28(2):133–143.
44.
ClarkJCarlsonRDSasakiCTPachnerARSteereAC. Facial paralysis in Lyme disease. Laryngoscope. 1985;95(11):1341–1345.
45.
HalperinJ.Lyme neuroborreliosis. Peripheral nervous system manifestations. Brain. 1990;113(4):1207–1221.
46.
BremellDHagbergL. Clinical characteristics and cerebrospinal fluid parameters in patients with peripheral facial palsy caused by Lyme neuroborreliosis compared with facial palsy of unknown origin (Bell’s palsy). BMC Infect Dis. 2011;11(1):1–6.
47.
PfisterHWEinhäuplKPreac-MursicVWilskeBSchierzG. The spirochetal etiology of lymphocytic meningoradiculitis of Bannwarth (Bannwarth’s syndrome). J Neurol. 1984;231(3):141–144.
48.
EppesSCNelsonDKLewisLLKleinJD. Characterization of Lyme meningitis and comparison with viral meningitis in children. Pediatrics. 1999;103(5):957–960.
49.
TuerlinckxDBodartEJamartJGlupczynskiY. Prediction of Lyme meningitis based on a logistic regression model using clinical and cerebrospinal fluid analysis: a European study. Pediatr Infect Dis J. 2009;28(5):394–397.
50.
ShahSSZaoutisTETurnquistJHodinkaRLCoffinSE. Early differentiation of Lyme from enteroviral meningitis. Pediatr Infect Dis J. 2005;24(6):542–545.
51.
NadelmanRBHanincováKMukherjeeP. Differentiation of reinfection from relapse in recurrent Lyme disease. N Engl J Med. 2012;367(20):1883–1890.
52.
WormserGPDattwylerRJShapiroED. The clinical assessment, treatment, and prevention of Lyme disease, human granulocytic anaplasmosis, and babesiosis: clinical practice guidelines by the infectious diseases society of America. Clin Infect Dis. 2006;43(9):1089–1134.
53.
NyatiKKNyatiR. Role of Campylobacter jejuni infection in the pathogenesis of Guillain-Barré syndrome: an update. Biomed Res Int. 2013;2013:1–13.
54.
ReesJHSoudainSEGregsonNAHughesRA. Campylobacter jejuni infection and Guillain–Barré syndrome. N Engl J Med. 1995;333(21):1374–1379.
55.
MishuBIlyasAAKoskiCL. Serologic evidence of previous Campylobacter jejuni infection in patients with the Guillain-Barré syndrome. Ann Intern Med. 1993;118(12):947–953.
56.
Van DoornPARutsLJacobsBC. Clinical features, pathogenesis, and treatment of Guillain-Barré syndrome. Lancet Neurol. 2008;7(10):939–950.
57.
HughesRASwanAVvan DoornPA.Intravenous immunoglobulin for Guillain-Barré syndrome. In: The Cochrane Collaboration, HughesRA, eds. Cochrane Database of Systematic Reviews. Chichester, UK: John Wiley & Sons, Ltd; 2012;7.
58.
HadfieldTLMcEvoyPPolotskyYTzinserlingVAYakovlevAA. The pathology of diphtheria. J Infect Dis. 2000;181(suppl 1):S116–S120.
DyeC. Global burden of tuberculosis: estimated incidence, prevalence, and mortality by country. JAMA. 1999;282(7):677–686.
65.
PhypersMHarrisTPowerC. CNS tuberculosis: a longitudinal analysis of epidemiological and clinical features. Int J Tuberc Lung Dis. 2006;10(1):99–103.
66.
SharmaPGargRKVermaRSinghMKShuklaR. Incidence, predictors and prognostic value of cranial nerve involvement in patients with tuberculous meningitis: a retrospective evaluation. Eur J Intern Med. 2011;22(3):289–295.
67.
Le PageLFeydyARillardonL. Spinal tuberculosis: a longitudinal study with clinical, laboratory, and imaging outcomes. Semin Arthritis Rheum. 2006;36(2):124–129.
68.
ThwaitesGEHienTT. Tuberculous meningitis: many questions, too few answers. Lancet Neurol. 2005;4(3):160–170.
69.
RodriguesLCLockwoodDN. Leprosy now: epidemiology, progress, challenges, and research gaps. Lancet Infect Dis. 2011;11(6):464–470.
70.
OoiWShrinivasanJ. Leprosy and the peripheral nervous system. Muscle Nerve. 2004;30(4):393–409.
71.
AgrawalAPanditLDalalMShettyJP. Neurological manifestations of Hansen’s disease and their management. Clin Neurol Neurosurg. 2005;107(6):445–454.
WagenaarIBrandsmaWPostE. Two randomized controlled clinical trials to study the effectiveness of prednisolone treatment in preventing and restoring clinical nerve function loss in leprosy: the TENLEP study protocols. BMC Neurol. 2012;12(1):159.
74.
RassiARassiAMarcondes de RezendeJ. American trypanosomiasis (Chagas disease). Infect Dis Clin North Am. 2012;26(2):275–291.
75.
GenoveseOBallarioCStorinoRSeguraESicaRE. Clinical manifestations of peripheral nervous system involvement in human chronic Chagas disease. Arq Neuropsiquiatr. 1996;54(2):190–196.
76.
GoinJCVeneraGBoninoMSterin-BordaL. Circulating antibodies against nicotinic acetylcholine receptors in chagasic patients. Clin Exp Immunol. 1997;110(2):219–225.
77.
KuehnB. FDA warning and study highlight fluoroquinolone risks. JAMA. 2013;310(10):1014.
78.
KassJSShanderaWX. Nervous system effects of antituberculosis therapy. CNS Drugs. 2010;24(8):655–667.
79.
RhoJSiaICrumBDekutoskiMTrousdaleR. Linezolid-associated peripheral neuropathy. Mayo Clin Proc. 2004;79(7):927–930.