Infectious Diseases of the Hypothalamic-Pituitary Axis

The hypothalamus is susceptible to a myriad of infections as well as noninfectious inflammatory lesions. Meningeal infections involving the base of the skull are particularly prone to affect the hypothalamus and the hypophysis many times with irreversible hormonal deficits. Syphilis remains a global pathogen. Fortunately, syphilis involving the hypothalamus is now rare, thanks to access to antibiotics and the fact that the Treponema remains sensitive to penicillin. Lyme disease also affects the hypothalamus in some cases. Viral infections of the hypothalamus are very interesting. Hantavirus is an emerging pathogen that is prone to affect the hypothalamus and hypophysis. Von Economo’s encephalitis is a historical disease that helped prove that the hypothalamus is a critical regulator of sleep. The pathogen in von Economo’s encephalitis evaded identification. Hopefully, the opportunity to identify the virus again due to a new epidemic will not materialize. The hypothalamus was affected due to various infections in patients with HIV-AIDS. Viral proteins can also interfere with hypothalamic function. Antiretroviral therapy changed the trajectory of the AIDS epidemic making AIDS cases far less common these days. However, HIV can remain in the brain because of the low penetrance of antiretrovirals. The Discussion is separated into two chapters, the first concentrating on infectious diseases of the hypothalamic-pituitary axis and the second on the noninfectious inflammatory lesions of the hypothalamic-pituitary axis.