Despite advances in antimicrobial chemotherapy, central nervous system infections continue to be an important cause of morbidity and mortality in infants. It is expected that as a result of bacterial vaccine improvements, the incidence of bacterial meningitis will decline in the near future. In the meantime, however, adjunctive therapeutic approaches, oriented to diminish brain inflammation, are proving valuable. An improved prognosis for survivors indicates a normal neurologic outcome for more than 80% of survivors. Other advances include rapid diagnostic techniques for viral and tuberculous central nervous system infections as well as short, intensive chemotherapeutic courses for the latter. Finally, imidazole antifungal agents are of potential value in pediatric infections.