Sepsis-associated encephalopathy and septic encephalitis: an update.

Area of Science:

• Neurology
• Infectious Diseases
• Critical Care Medicine

Background:

• Sepsis-associated encephalopathy (SAE) and septic encephalitis (SE) are severe neurological complications of sepsis.
• These conditions are linked to high mortality rates, persistent cognitive deficits, and focal neurological impairments.

Purpose of the Study:

• To review the clinical manifestations, underlying pathophysiology, and treatment strategies for SAE and SE.
• To explore emerging diagnostic and therapeutic approaches for these sepsis-induced brain injuries.

Main Methods:

• Literature review of the PUBMED database (2016-2020).
• Analysis of clinical presentations, pathological mechanisms, and treatment outcomes for SAE and SE.
• Evaluation of experimental therapeutic strategies and diagnostic advancements.

Main Results:

• SAE primarily presents as delirium, while SE includes focal neurological symptoms.
• Pathophysiology involves inflammation, blood-brain barrier disruption, hypoxia, and neurotransmitter imbalance.
• Septic-embolic (SEE) and septic-metastatic encephalitis (SME) represent distinct but related entities characterized by ischemia and abscesses, respectively.

Conclusions:

• Rapid, optimal antibiotic therapy is the cornerstone of treatment for SAE and SE.
• Emerging treatments focus on anti-inflammatory agents, blood-brain barrier stabilization, and mitochondrial function restoration.
• Novel imaging techniques show promise for diagnosis, and certain repurposed drugs may offer therapeutic benefits.