Most of the literature on infectious disease and the CNS has focused on broader aspects of cognitive and behavioral functioning with less emphasis on EF. However, the role of EF in mediating some behavioral and functional outcomes, as well as recognition of the potential for infectious diseases to strike at various points during the protracted development of brain regions subserving EF, has increased interest in this area.
Infectious diseases vary in their actions on the CNS, including direct attacks and secondary effects such as encephalitis (irritation and inflammation of the brain), meningitis (inflammation of the protective membranes covering the brain and spinal cord), or encephalomyelitis (a.k.a. myeloencephalitis; inflammation of the brain and meninges). Acute disseminated encephalomyelitis (ADEM) can occur following infection, and is associated with damage to white matter.
Infectious disease impacting the CNS can be bacterial in nature, including Bartonella henselae (a.k.a. “cat scratch disease”), the Borrelia family (causing Lyme disease), and Mycobacterium tuberculosis (TB). Viral causes of CNS inflammation in pediatric populations include the herpes viruses (including herpes simplex, Epstein–Barr, and varicellazoster), cytomegalovirus (CMV), mosquito- and tick-borne viruses, and enteroviruses (e.g., poliovirus, echovirus, coxsackievirus). Although measles, mumps, rabies, rubella, streptococcus pneumonia, and haemophilus influenza type B were cause for concern in the past, they are less prevalent now in the United States given the effectiveness of immunizations.