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Clinical Microbiology Reviews, April 2004, p. 323-347, Vol. 17, No. 2
0893-8512/04/$08.00+0     DOI: 10.1128/CMR.17.2.323-347.2004
Copyright © 2004, American Society for Microbiology. All Rights Reserved.

Invasion of the Central Nervous System by Intracellular Bacteria

Douglas A. Drevets,1* Pieter J. M. Leenen,2 and Ronald A. Greenfield1

Department of Medicine, Oklahoma University Health Sciences Center and the Veterans Affairs Medical Center, Oklahoma City, Oklahoma,1 Department of Immunology, Erasmus MC, Rotterdam, The Netherlands2

Infection of the central nervous system (CNS) is a severe and frequently fatal event during the course of many diseases caused by microbes with predominantly intracellular life cycles. Examples of these include the facultative intracellular bacteria Listeria monocytogenes, Mycobacterium tuberculosis, and Brucella and Salmonella spp. and obligate intracellular microbes of the Rickettsiaceae family and Tropheryma whipplei. Unfortunately, the mechanisms used by intracellular bacterial pathogens to enter the CNS are less well known than those used by bacterial pathogens with an extracellular life cycle. The goal of this review is to elaborate on the means by which intracellular bacterial pathogens establish infection within the CNS. This review encompasses the clinical and pathological findings that pertain to the CNS infection in humans and includes experimental data from animal models that illuminate how these microbes enter the CNS. Recent experimental data showing that L. monocytogenes can invade the CNS by more than one mechanism make it a useful model for discussing the various routes for neuroinvasion used by intracellular bacterial pathogens.

* Corresponding author. Mailing address: VAMC 111/C, 921 NE 13th St., Oklahoma City, OK 73104. Phone: (405) 270-0501 ext. 3284. Fax: (405) 297-5934. E-mail: douglas-drevets{at}ouhsc.edu.

Clinical Microbiology Reviews, April 2004, p. 323-347, Vol. 17, No. 2
0893-8512/04/$08.00+0     DOI: 10.1128/CMR.17.2.323-347.2004
Copyright © 2004, American Society for Microbiology. All Rights Reserved.



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