The interface between stroke and infectious disease: infectious diseases leading to stroke and infections complicating stroke.

It is well established that several infectious diseases can directly lead to ischemic or hemorrhagic stroke during their course. It appears possible that common viral and bacterial infections can increase the susceptibility to stroke by promoting atherosclerosis, inflammation, and local thrombosis. Stroke commonly leads to disruption of protective mechanisms against infection and induces a cascade of anti-inflammatory and immunosuppressive reactions, which greatly increases the risk of infection. The social and economic costs of post-stroke infections and their impact on stroke morbidity and outcome are dramatic. Understanding the pathophysiologic links between stroke and infection is therefore of paramount importance, and effective preventive strategies to reduce the risk of infection are needed. This article summarizes current clinical and experimental data regarding the interactions between stroke and infection and outlines possible targets for therapeutic intervention.