The human central nervous system (CNS) infections remain the leading cause of intensified morbidity and mortality rates around the world. Vanquish the barriers that protect the brain from pathogens is a prerequisite to develop meningitis. The commonest pathogens, pneumococcus, meningococcus, E. coli, H. influenzae are main causative agents in children and adults; are associated with high morbidity and mortality. Bacteria have evolved a variety of different strategies for breaching the blood–brain barrier (BBB), evade the immune system and enter CNS. For this purpose, they use a variety of different virulence factors, allowing them to adhere to and overcome these barriers. These virulence factors arbitrate adhesion host cell invasion, intracellular survival, host cell signaling and induction of inflammation. The CNS will ultimately be invaded by the bacteria, causing inflammation of meninges, increased permeability of BBB, and pleocytosis in cerebrospinal fluid (CSF) as well as nervous tissue infiltration. Some of these mechanisms are different, but others are shared by some pathogens. Supplementary understanding of these processes, especially, differences between the blood-brain barrier and the blood-cerebrospinal fluid barrier, and Virulence factors used by pathogens are still required.
















