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Prenatal and Neonatal Infections of the Central Nervous System

Linda S de Vries1, Vincent Bekker2, Sylke J Steggerda2

  • 1Division of Neonatology, Department of Pediatrics, Willem-Alexander Children's Hospital, Leiden University Medical Center (LUMC), Leiden, The Netherlands; Department of Neonatology, University Medical Center Utrecht (UMCU), Utrecht, The Netherlands.

Pediatric Clinics of North America
|October 12, 2025
PubMed

Insights

Central nervous system infections in newborns, though rare, are severe and can cause brain injury. Imaging like ultrasound and MRI can help identify the pathogen and track lesion evolution for better outcomes.

Area of Science:

  • Neurology
  • Infectious Diseases
  • Pediatrics

Background:

  • Central nervous system (CNS) infections in newborns are uncommon but carry significant risks.
  • Bacterial, fungal, and viral pathogens can cause severe, potentially devastating brain injury in neonates.
  • Each pathogen presents a distinct pattern of brain lesions.

Purpose of the Study:

  • To highlight the role of neuroimaging in diagnosing CNS infections in newborns.
  • To emphasize the importance of identifying causative pathogens based on lesion patterns.
  • To underscore the need for monitoring lesion evolution and long-term outcomes.

Main Methods:

  • Review of neuroimaging findings (cranial ultrasound, MRI) in neonatal CNS infections.
  • Correlation of specific lesion patterns with bacterial, fungal, and viral pathogens.
  • Assessment of lesion evolution and complications such as abscess, cystic changes, and hydrocephalus.

Main Results:

  • Neuroimaging features can suggest the specific causative pathogen in neonatal CNS infections.
  • Serial neuroimaging is crucial for diagnosing evolving complications.
  • Outcomes vary significantly depending on the identified pathogen.

Conclusions:

  • Cranial ultrasound and MRI are valuable tools for early pathogen suggestion in neonatal CNS infections.
  • Monitoring lesion evolution with repeat neuroimaging is essential for managing complications.
  • Long-term follow-up is recommended due to variable outcomes among different pathogens.
Keywords:
CNS infectionCranial ultrasoundMRINeuro-imagingNewborn

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