title: Septic encephalopathy and septic encephalitis‬‬.
abstract: During the last two decades, septic encephalopathy (SE) was recognized as a clinically relevant problem with a high prevalence in patients at admission and during their hospital stay. SE is a condition associated with increased mortality and morbidity such as long-term cognitive impairment. Areas covered: This review illustrates the pathophysiology of sepsis-associated encephalopathy and encephalitis involving blood-brain-barrier dysfunction and neuroinflammation caused by endothelial and microglial activation by endogenous or pathogen-derived compounds, hypoxia by impaired microvascular regulation and septic shock as well as imbalance of neurotransmitters. The continuum between septic-embolic and septic-metastatic encephalitis and SE is underlined by histological findings. The options of technical examinations and biomarkers to diagnose SE are discussed together with established therapeutic options as well as current experimental approaches. Expert commentary: An outlook for clinicians is provided including promising diagnostic approaches by means of new imaging techniques. Clinical trials with drugs already established for other indications such as statins, erythropoietin and minocycline are warranted in the future.
authors.affiliation: a Department of Neurology , RWTH University Hospital , Aachen , Germany.
authors.forename: Simone C
authors.initials: SC
authors.lastname: Tauber
authors.affiliation: b Department of Medical Microbiology , Georg-August-University , Göttingen , Germany.
authors.forename: Helmut
authors.initials: H
authors.lastname: Eiffert
authors.affiliation: c Department of Neuropathology , Georg-August-University , Göttingen , Germany.
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Brück
authors.affiliation: c Department of Neuropathology , Georg-August-University , Göttingen , Germany.|d Department of Geriatrics , Evangelisches Krankenhaus Göttingen-Weende , Göttingen , Germany.
authors.forename: Roland
authors.initials: R
authors.lastname: Nau
mesh_terms: D015415:Biomarkers / Q000032:analysis; D001812:Blood-Brain Barrier / Q000000981:diagnostic imaging / Q000276:immunology / Q000503:physiopathology*; D001927:Brain Diseases / Q000000981:diagnostic imaging / Q000209:etiology* / Q000401:mortality / Q000517:prevention & control; D016207:Cytokines / Q000276:immunology; D006706:Homeostasis; D006801:Humans; D000069544:Infectious Encephalitis / Q000000981:diagnostic imaging / Q000209:etiology* / Q000401:mortality / Q000517:prevention & control; D018377:Neurotransmitter Agents / Q000378:metabolism; D018805:Sepsis / Q000150:complications* / Q000000981:diagnostic imaging / Q000401:mortality / Q000628:therapy
chemical_list: D015415:Biomarkers; D016207:Cytokines; D018377:Neurotransmitter Agents
keywords: Sepsis; cognitive impairment; microglial activation; neuroinflammation; septic encelopathy