NCCEd: Neurocritical Care Education for Residents

Objective: Interpret clinical and radiographic data in diagnosing meningoencephalitis and distinguishing between the infectious etiologies (e.g. bacterial, viral, fungal)

Rationale: CNS infection is an important postoperative complication and may also require neurosurgical intervention (e.g. CSF diversion). Identifying this early leads to timely appropriate therapeutic intervention, improving morbidity and mortality.

Objective: Interpret clinical and radiographic data to support or refute a diagnosis of pneumonia or pneumonitis

Rationale: Pneumonia is incredibly common in acutely ill neurosurgical patients, but there is no single test that confirms the diagnosis. Instead, several data points must be interpreted. Aspiration pneumonitis is often misdiagnosed as pneumonia. As infection is often thought to be a trigger for exacerbation of chronic neurologic illnesses, accurate diagnosis must be made to avoid premature diagnostic satisfaction and minimize inappropriate antimicrobial therapy. ATS and IDSA have consensus guidelines on the diagnosis and management of patients with community-acquired, hospital-acquired, and ventilator-associated pneumonia.

Objective: Interpret clinical data to support or refute a diagnosis of urinary tract infection

Rationale: Urinary tract infections are commonly found in acute neurosurgical patients, whether as a cause for their symptoms or even as a result of their deficits. However, UTIs are frequently over-diagnosed, which can negatively impact patient outcomes and contribute to antimicrobial resistance. As infection is often thought to be a trigger for exacerbation of chronic neurologic illnesses, accurate diagnosis must be made to avoid premature diagnostic satisfaction.