Septic metastatic encephalitis: coexistence of brain damage and repair

S. C. Tauber, S. Bunkowski, W. Brück and R. Nau (2011) Neuropathology and Applied Neurobiology 37, 768–776 Septic metastatic encephalitis: coexistence of brain damage and repair Aims: Septic metastatic encephalitis (SME) arises from systemic bacterial infections and is a severe complication of sepsis with a high mortality. In this study, we examined the neuropathological findings in humans suffering from SME including white matter pathology and proliferation of neural precursor cells in the hippocampal dentate gyrus. Methods: The brains of 10 autopsy cases with SME and 10 control cases after sudden death from non‐neurological causes were studied by means of immunohistochemistry. Results: We found diffuse axonal injury and demyelination in the frontal cortex ( P = 0.01) as well as increased numbers of recently generated TUC‐4 expressing neurones in the hippocampal dentate gyrus in SME cases ( P = 0.01). The median density of apoptotic granule cells in the dentate gyrus also was higher in SME cases, the difference, however, failed to reach statistical significance ( P = 0.25). Conclusion: The coexistence of degenerative processes predominantly in the neocortex and regenerative activity in the hippocampal formation known from bacterial meningitis also characterizes the pathology of SME.