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In Bolivia, aetiologies, case fatality, and determinants of outcome are poorly characterised. We attempted to investigate such parameters to guide diagnosis, treatment, prevention, and health policy. From Nov-2017 to Oct-2018, we prospectively enrolled 257 inpatients (20.2% HIV-positive patients) of all ages from healthcare centers of Cochabamba and Santa Cruz, Bolivia with a suspected CNS infection and a lumbar puncture performed. Biological diagnosis included classical microbiology, molecular, serological and immunohistochemical tests. An infectious aetiology was confirmed in 128\/257 (49.8%) inpatients, including, notably among confirmed single and co-infections, <jats:italic>Cryptococcus<\/jats:italic> spp. (41.7%) and <jats:italic>Mycobacterium tuberculosis<\/jats:italic> (27.8%) in HIV-positive patients, and <jats:italic>Mycobacterium tuberculosis<\/jats:italic> (26.1%) and <jats:italic>Streptococcus pneumoniae<\/jats:italic> (18.5%) in HIV-negative patients. The total mortality rate was high (94\/223, 42.1%), including six rabies cases. In multivariate logistic regression analysis, mortality was associated with thrombocytopenia (Odds ratio (OR) 5.40, 95%-CI 2.40\u201311.83) and hydrocephalus (OR 4.07, 95%-CI 1.35\u201312.23). The proportion of untreated HIV patients, late presentations of neurotuberculosis, the rate of pneumococcal cases, and rabies patients who did not benefit from a post-exposure prophylaxis, suggest that decreasing the burden of CNS infections requires reinforcing health policy regarding tuberculosis, rabies, <jats:italic>S. pneumoniae<\/jats:italic> vaccination, and HIV-infections.<\/jats:p>","DOI":"10.1038\/s41598-021-02592-6","type":"journal-article","created":{"date-parts":[[2021,12,1]],"date-time":"2021-12-01T11:04:42Z","timestamp":1638356682000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["A clinical, aetiological, and public health perspective on central nervous system infections in Bolivia, 2017\u20132018"],"prefix":"10.1038","volume":"11","author":[{"given":"Paola Mariela","family":"Saba Villarroel","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mar\u00eda del Rosario","family":"Castro Soto","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Oriana","family":"Melendres Flores","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alejandro","family":"Peralta Land\u00edvar","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mar\u00eda E.","family":"Calder\u00f3n","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Roxana","family":"Loayza","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jos\u00e9","family":"Boucraut","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Laurence","family":"Thirion","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Audrey","family":"Dubot-P\u00e9r\u00e8s","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Laetitia","family":"Ninove","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xavier","family":"de Lamballerie","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2021,12,1]]},"reference":[{"key":"2592_CR1","doi-asserted-by":"publisher","first-page":"2382","DOI":"10.1038\/srep02382","volume":"3","author":"A Giri","year":"2013","unstructured":"Giri, A. et al. 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