In the immunocompromised patient, even subtle neurologic signs must prompt evaluation for possible CNS infection. In one series, 60% of immunosuppressed cancer patients died as a result of CNS infection, although many had malignancies with less-than-fatal prognoses.139,192
A presentation of new-onset seizure obviously prompts a workup. An expedited search for infection is also mandated, however, when a seizure occurs in an iatrogenically immunosuppressed cancer patient with a seizure disorder secondary to a known brain tumor (either primary or metastatic).
Adapted from: Goldstein MA and Harden CL. Infectious states. In: Ettinger AB and Devinsky O, eds. Managing epilepsy and co-existing disorders. Boston: Butterworth-Heinemann; 2002;83-133.
With permission from Elsevier (www.elsevier.com).