EMERGENCY:Fever with severe headache and neck stiffness (suspected meningitis), or fever with confusion / behaviour change / seizure (suspected encephalitis) —call040-46324365immediately — 24 hours, 7 days— 24/7
Neuroinfectious Disorders & Complications:
Emergency Care, Specialist Diagnosis & Treatment
KIMS Neuroscience Hyderabad provides expert emergency and specialist care across the full course of neurological infection — from bacterial meningitis, herpes encephalitis, neurocysticercosis, HIV-related disorders, and prion disease to the complications that follow: meningitis and encephalitis sequelae, post-infectious encephalomyelitis, post-viral polyneuropathy, Rasmussen encephalitis, and SSPE. The same neurologists and neurosurgeons manage the infection and its complications.
14 Conditions
040-44885000
040-46324365
Infectious and post-infectious neurological disorders are conditions in which a pathogen (bacterial, viral, fungal, mycobacterial, parasitic, or prion) invades or damages the nervous system, or in which the body's immune response to a recent infection produces neurological injury. Several are time-critical neurological emergencies — bacterial meningitis and herpes simplex encephalitis are the two where the outcome depends almost entirely on how quickly the right treatment is started. KIMS Neuroscience Hyderabad provides 24-hour emergency assessment and treats: Meningitis (bacterial, viral, fungal, tuberculous) · Encephalitis · Herpes Simplex Encephalitis · Neurosyphilis · HIV-Associated Neurocognitive Disorders · Neurocysticercosis · Lyme Disease (Neurological) · Prion Diseases (CJD).
- What they are
- Neurological conditions caused by infection of the nervous system — meningitis, encephalitis, parasitic, fungal, and prion diseases — together with their complications and post-infectious sequelae, managed as one pathway by the same team. Several are time-critical neurological emergencies.
- Conditions treated
- Meningitis (bacterial, viral, fungal, tuberculous) · Encephalitis · Herpes Simplex Encephalitis · Neurosyphilis · HIV-Associated Neurocognitive Disorders · Neurocysticercosis · Lyme Disease · Prion Diseases (CJD) · Encephalitis Sequelae · Meningitis Sequelae · Post-Infectious Encephalomyelitis · Post-Viral Polyneuropathy · Rasmussen's Encephalitis · Subacute Sclerosing Panencephalitis (SSPE).
- The two not-to-miss emergencies
- Bacterial meningitis (fever + severe headache + neck stiffness) and herpes simplex encephalitis (fever + behaviour change + seizure) — the outcome of both depends almost entirely on speed of antibiotic or acyclovir treatment.
- India-specific patterns
- Tuberculous meningitis — India has the world's highest TB burden, TBM is the most common chronic meningitis · Neurocysticercosis causes ~1/3 of acquired epilepsy in India · Japanese encephalitis is endemic in Telangana (Jul–Nov) · Cryptococcal meningitis predominantly in immunocompromised patients.
- Diagnosis at KIMS
- Lumbar puncture and CSF analysis · CSF bacterial culture, viral PCR, fungal stains, AFB and TB PCR · MRI brain with infection-specific protocols (DWI, contrast) · 14-3-3 and RT-QuIC for prion disease · HIV testing in all unexplained CNS presentations.
- KIMS emergency protocol
- Empirical IV acyclovir is started in any encephalitis presentation while investigation proceeds — because delayed treatment of HSV encephalitis causes permanent temporal-lobe damage. Empirical antibiotics for suspected bacterial meningitis on the same principle.
- Contact KIMS
- Emergency: 040-46324365 (24/7) · Outpatient: 040-44885000 · neuroscience@kimshospitals.com · No referral required
| Fact | Details |
|---|---|
| Conditions covered | Meningitis (bacterial, viral, fungal, TB) · Encephalitis · Herpes Simplex Encephalitis · Neurosyphilis · HIV-Associated Neurocognitive Disorders · Neurocysticercosis · Lyme Neuroborreliosis · Prion Diseases (CJD) · Encephalitis Sequelae · Meningitis Sequelae · Post-Infectious Encephalomyelitis · Post-Viral Polyneuropathy · Rasmussen's Encephalitis · Subacute Sclerosing Panencephalitis (SSPE) |
| Bacterial meningitis triad | Fever + severe headache + neck stiffness + photophobia · Add purpuric rash = meningococcal septicaemia (emergency) · LP and empirical antibiotics before delay |
| HSV encephalitis | Most common cause of fatal sporadic encephalitis globally · Outcome correlates with how quickly IV acyclovir starts · Start empirical acyclovir before PCR confirmation in any encephalitis presentation |
| TB meningitis in India | Highest global TB burden · Subacute presentation · Treated with antitubercular therapy (ATT) plus corticosteroids · CSF AFB, TB PCR, and CSF ADA at KIMS |
| Neurocysticercosis | Approximately 1/3 of acquired adult epilepsy in India · First adult seizure prompts MRI with contrast for ring-enhancing lesions · Treated with albendazole + praziquantel + steroids |
| Japanese encephalitis | Endemic in Telangana, seasonal (Jul–Nov) · JE vaccine in national schedule in endemic areas but coverage incomplete · Supportive treatment only |
| Contact | 040-46324365 (emergency, 24/7) · 040-44885000 (outpatient) · No referral required |
Fever + Severe Headache + Neck Stiffness = Medical Emergency
Bacterial meningitis kills in hours. Do not drive. Do not wait until morning. Call an ambulance immediately.
What Are Infectious Neurological Disorders?
Infectious diseases of the nervous system are among the most urgent conditions in all of medicine. Bacterial meningitis kills within hours of symptom onset if untreated, and survivors frequently sustain permanent hearing loss, cognitive impairment, or limb loss from sepsis. Herpes simplex encephalitis destroys the temporal lobes within days without antiviral treatment. A young adult presenting to KIMS with fever, severe headache, neck stiffness, and drowsiness is a neurological emergency until proven otherwise.
India carries a disproportionate burden of infectious neurological disease. Meningitis incidence is estimated at 60–80 per 100,000 with approximately 60,000 deaths annually. Neurocysticercosis is responsible for approximately one-third of all cases of acquired epilepsy in India, affecting an estimated 1 million Indians. Japanese encephalitis remains endemic across Telangana with case fatality rates of 20–30%. Tuberculous meningitis remains the most common cause of chronic meningitis across the country.
At KIMS Neuroscience, Secunderabad, the Infectious Neurological Disorders programme provides 24-hour emergency neurological assessment, lumbar puncture and CSF analysis with rapid pathogen identification, MRI brain with specific infection protocols, antiviral and antimicrobial therapy, management of raised intracranial pressure and seizures, and specialist outpatient management of neurosyphilis, HAND, and prion diseases.
Warning Signs to Watch For
• Severe headache (worst of life)
• Fever with neck stiffness
• Photophobia or phonophobia
• Non-blanching rash (purpura)
• Drowsiness or confusion
• New-onset seizure with fever
Conditions We Treat
01
Meningitis (Bacterial, Viral, Fungal)
Inflammation of the meninges from bacterial, viral, or fungal infection. Bacterial meningitis is a life-threatening emergency: fever + severe headache + neck stiffness + photophobia. Tuberculous meningitis is the most common chronic meningitis in India.
View Details →02
Encephalitis
Inflammation of the brain parenchyma producing altered consciousness, behaviour change, seizures, and focal deficits alongside fever. Causes in India include Japanese encephalitis, enteroviruses, dengue, scrub typhus, and autoimmune encephalitis.
View Details →03
Herpes Simplex Encephalitis
The most common cause of fatal sporadic encephalitis globally. HSV-1 infects the temporal lobes producing fever, behaviour change, seizures, and rapid consciousness decline. Outcome depends entirely on speed of IV acyclovir.
View Details →04
Neurosyphilis
Invasion of the nervous system by Treponema pallidum in late or inadequately treated syphilis. Presents variably from asymptomatic to meningovascular stroke-like and parenchymal forms. Re-emerging in India.
View Details →05
HIV-Associated Neurocognitive Disorders (HAND)
A spectrum of neurological and cognitive impairment in HIV-positive individuals, from ANI and MND to HIV-Associated Dementia. Opportunistic infections complicate advanced HIV. ART significantly reduces risk.
View Details →06
Neurocysticercosis
Most common parasitic infection of the nervous system and the leading cause of acquired epilepsy in India. Caused by Taenia solium larvae from contaminated food/water. Treated with albendazole + praziquantel + steroids.
View Details →07
Lyme Disease (Neurological)
Neurological complications of Borrelia burgdorferi infection, termed Lyme Neuroborreliosis. Includes facial palsy, radiculopathy, lymphocytic meningitis, and rarely encephalopathy. Treated with IV ceftriaxone or oral doxycycline.
View Details →08
Prion Diseases (Creutzfeldt-Jakob Disease)
Fatal progressive diseases caused by misfolded prion proteins. CJD presents with rapidly progressive dementia, myoclonus, ataxia, and psychiatric features. Diagnosis by MRI DWI, 14-3-3 protein in CSF, RT-QuIC.
View Details →09
Encephalitis Sequelae
Inflammation of the brain itself — from herpes, Japanese encephalitis, dengue, scrub typhus, chikungunya, and (rarely) post-vaccination. Causes fever, confusion, seizures, and behavioural change. Some forms have specific treatments (acyclovir for herpes). Others — including ADEM and autoimmune encephalitis after infection — respond to steroids, IVIG, or plasmapheresis.
View Details →10
Meningitis Sequelae
Bacterial, tuberculous, viral, and fungal infections of the lining around the brain. Long-term effects can include hearing loss, hydrocephalus (water on the brain), seizures, and learning problems in children. Tuberculous meningitis (TBM) remains a major cause of disability in India and needs months of treatment plus close neurological follow-up.
View Details →11
Post-Infectious Encephalomyelitis
Inflammation of the brain and spinal cord triggered by an infection or, rarely, vaccination. A monophasic attack that responds to steroids, IVIG, or plasmapheresis in most cases.
View Details →12
Post-Viral Polyneuropathy
Damage to peripheral nerves following a viral illness. Presents as weakness, numbness, or burning pain in the limbs. Treatment depends on the underlying cause and may include immunotherapy and supportive rehabilitation.
View Details →13
Rasmussen's Encephalitis
A rare, progressive inflammatory disease of one cerebral hemisphere in children, causing intractable focal seizures and hemiparesis. Treatment may include immunotherapy and, in selected cases, hemispherectomy.
View Details →14
Subacute Sclerosing Panencephalitis (SSPE)
A delayed, slowly progressive brain inflammation caused by persistent measles virus. Largely preventable through measles immunisation. Multidisciplinary symptomatic care at KIMS for affected children and families.
View Details →India-Specific Clinical Context
Why the infectious neurology landscape in India differs from international guidelines.
The fever + headache + neck stiffness triad
Any person with this combination has bacterial meningitis until proven otherwise. In India, delayed presentation and delayed LP are the two main contributors to poor outcomes.
Tuberculous meningitis — India's specific burden
India has the world's highest TB burden. TBM presents subacutely and is the most common cause of chronic meningitis. Treated with antitubercular therapy (ATT) plus steroids.
Neurocysticercosis — the epilepsy driver
NCC causes approximately one-third of acquired epilepsy in India. Any first seizure in an adult deserves MRI with contrast to look for ring-enhancing lesions.
Japanese encephalitis
Remains endemic in Telangana, seasonal (July–November). JE vaccination is now in the national immunisation schedule in endemic areas but coverage is incomplete. Treatment is supportive.
Herpes simplex encephalitis — the treatable emergency
Outcome depends entirely on how quickly acyclovir is started. KIMS protocol: start empirical acyclovir in any encephalitis presentation, while investigation proceeds.
Cryptococcal meningitis
The most common fungal meningitis, predominantly in immunocompromised patients. Treatment: liposomal amphotericin B + flucytosine induction, then fluconazole maintenance.
The KIMS Treatment Pillars
24-Hour Emergency Assessment
Round-the-clock neurological evaluation for acute meningitis and encephalitis presentations.
Rapid Pathogen Identification
Lumbar puncture and CSF analysis with prompt bacterial, viral, fungal, and TB workup.
Specialist MRI Protocols
MRI brain with infection-specific protocols including contrast and DWI sequences for HSE and prion disease.
Multidisciplinary Antimicrobial Care
Antiviral (acyclovir), antibacterial, antitubercular, and antifungal therapy with raised-ICP and seizure management.
Expert Consultation
Our infectious neurology team reviews every case 24/7. For emergencies, call directly — no referral required.
Why Choose KIMS Neuroscience?
24-Hour Emergency Neurology Cover
Rapid CSF Analysis & Pathogen Panels
Empirical Acyclovir Protocol for Encephalitis
TB, Cryptococcal & NCC Expertise
Common Questions
Meningitis is infection of the membranes covering the brain (the meninges). Encephalitis is infection of the brain tissue itself. Both cause fever and severe headache; encephalitis additionally produces altered consciousness, behaviour change, and seizures. Both are emergencies requiring immediate hospital assessment. Call 040-46324365.
The classic triad: very severe headache (often described as the worst headache of their life), fever, and neck stiffness (unable to flex the chin to the chest). Other warning signs: sensitivity to light (photophobia), sensitivity to sound (phonophobia), non-blanching rash (purpura — a medical emergency indicating meningococcal septicaemia), drowsiness, confusion, or seizures. Any combination of these in a previously well person is a medical emergency. Do not wait — call 040-46324365 immediately.
Not directly. Neurocysticercosis is caused by accidentally ingesting the eggs of the pork tapeworm (Taenia solium) through contaminated food or water — particularly from faecal-oral transmission. A person who eats pork can get intestinal tapeworm. A person who swallows tapeworm eggs (from contaminated food, water, or poor hand hygiene) can get NCC. Vegetarians can get NCC if they eat food contaminated with tapeworm eggs. It is fundamentally a food hygiene and sanitation disease. The best protection is washing vegetables thoroughly, drinking safe water, and washing hands.
Outcome depends almost entirely on how quickly IV acyclovir is started. When treatment begins within the first 24–48 hours of encephalitis symptoms: many patients recover with good or full neurological function. When delayed beyond 72–96 hours: a significant proportion of patients sustain permanent memory loss, personality change, language impairment, or epilepsy from temporal lobe damage. This is why herpes encephalitis is the condition where speed of treatment saves brains, not just lives. If you or someone you care for has fever + confusion + seizure — call 040-46324365 immediately, not tomorrow.
HIV can affect the nervous system directly and through opportunistic infections. Direct HIV effects: cognitive impairment (difficulty concentrating, memory problems — HIV-associated neurocognitive disorder, HAND), peripheral neuropathy (numbness and pain in feet), and in advanced disease, HIV-associated dementia. Opportunistic infections in untreated or poorly-controlled HIV: cryptococcal meningitis (fungal), toxoplasma brain abscess, PML (progressive multifocal leukoencephalopathy), CMV encephalitis. Effective antiretroviral therapy (ART) dramatically reduces the risk of all these. If you are HIV-positive with new neurological symptoms, call 040-44885000.
Bacterial meningitis (S. pneumoniae, N. meningitidis, H. influenzae) is typically acute — symptoms develop over hours to a couple of days, with high fever, severe headache, and neck stiffness. Tuberculous meningitis (M. tuberculosis) is subacute — symptoms build over 1–4 weeks with low-grade fever, gradually worsening headache, lethargy, and personality change. CSF in bacterial meningitis shows neutrophil predominance and high protein; CSF in TBM shows lymphocyte predominance, high protein, and very low glucose. India has the world's highest TB burden so TBM must be specifically excluded in any subacute meningitis. Treated with antitubercular therapy and steroids. Call 040-46324365 if symptoms are progressing.
Yes — direct appointments are accepted. Outpatient: 040-44885000 (Mon–Sat). For fever with severe headache, neck stiffness, confusion, seizure, or any rapidly deteriorating neurological symptom — call 040-46324365 immediately. Do not wait for an outpatient slot.
Every Infectious Neurological Disorder Requires Specialist Assessment
From neurocysticercosis causing a first seizure to HIV-related cognitive decline and rare prion disease presentations — KIMS Neuroscience offers 24-hour emergency assessment and specialist outpatient care.
Emergency: 040-46324365 · Appointments: 040-44885000 · neuroscience@kimshospitals.com