Objective:

This study aims to conduct a comprehensive literature review to identify and categorize neuroinfectious diseases that manifest as stroke or stroke mimics. It seeks to illuminate the variety of pathogens associated with stroke-like presentations, offering insights into their effects on neurological health and expanding awareness among neurologists.

Background:

Neuroinfections comprise a range of conditions affecting the nervous system, caused by various pathogens such as viruses, bacteria, fungi, and parasites. These infections can often present with symptoms that simulate stroke, creating diagnostic challenges.

Design/Methods:

A systematic search of publications from the past decade using databases such as Google Scholar and PubMed was conducted in September. Keywords included stroke, stroke mimic, viral encephalitis, bacterial meningitis, and neuroborreliosis. Advanced search techniques were employed, focusing on article titles. After applying filters and removing duplicates, 65 articles were selected for inclusion. Screening criteria were designed to align with the study's objectives and minimize bias. Exclusion criteria included articles with incorrect outcomes, non-English publications, and those published before 2014.

Results:

Of the 65 studies included, viral infections made up 43%, with SARS-CoV, herpes, and varicella being the most common. Bacterial meningitis, particularly due to tuberculosis, pneumococcus, and E. coli, accounted for 18%, while fungal meningitis comprised 10%. Spirochetes, such as neurosyphilis and neuroborreliosis, were discussed in 18 studies, with neurocysticercosis mentioned in one case.

Conclusions:

This review highlights the wide range of neuroinfectious diseases that can cause stroke or mimic its clinical presentation. Understanding these associations is vital for accurate diagnosis and timely management, especially in cases lacking traditional stroke risk factors or in atypical presentations. The study underscores the necessity for a multidisciplinary approach involving neurologists, infectious disease specialists, and neuroradiologists for optimal patient care. Overall, it emphasizes the importance of considering infectious etiologies in stroke evaluations, particularly in endemic regions.