Levels of cerebrospinal fluid and serum acetylcholinesterase in Tuberculous and pyogenic meningitis in children

Meningitis is referred to as an inflammatory process of the leptomeninges and cerebrospinal fluid (CSF) within the sub-arachnoid space of the brain. We have investigated glucose status in CSF in different types of meningitis together with detailed medical history in children. In addition, we have also carried out the detailed cytological and microbiological examinations. A total of 40 subjects were investigated. We observed that the glucose level was significantly decreased (<20 mg/dl) in 65%, moderately decreased (20-40 mg/dl) in 20% and mildly decreased (40-50mg/dl) in 15% of the patients in our study. Patients with Pyogenic meningitis had tremendously reduced glucose level (9.0 mg/dl) in their CSF whereas in viral meningitis the CSF glucose level is highly variable (10 to 65 mg/dl). Furthermore, 5 (12.5%) patients showed high lymphocyte counts and 34 (85%) patients showed high neutrophil counts. Interestingly, in Pyogenic meningitis, the neutrophil count was very high compared to that in viral meningitis. The present study clearly demonstrates that biochemical parameters such as glucose level in CSF might be a potential tool for detecting meningitis and as well as differentiation of the different types of meningitis. DOI: http://dx.doi.org/10.3329/cujbs.v6i1-2.17080 The Chittagong Univ. J. B. Sci.,Vol. 6(1&2):41-49, 2011

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Correlation of the Laboratory Findings with a Etiology of Patients Presenting with Fever followed by Altered Consciousness in a Teaching Hospital

TAJ Journal of Teachers Association ◽

10.3329/taj.v18i1.3300 ◽

1970 ◽

Vol 18 (1) ◽

pp. 25-29

Author(s):

Amaresh Chandra Shaha ◽

Manabendra Nath Nag ◽

Arpita Deb ◽

NC Nath

Keyword(s):

Cerebrospinal Fluid ◽

Altered Consciousness ◽

Pyogenic Meningitis ◽

Tubercular Meningitis ◽

College Hospital ◽

Laboratory Findings ◽

Medical College ◽

Group 2 ◽

Medical Wards ◽

Very High

Consecutive fifty subjects having fever with altered consciousness admitted into medical wards in Rangpur Medical College Hospital, Rangpur were selected to find out the aetiology and its correlation with laboratory findings of the subjects. Subjects having prolonged fever, (more than 21 days) pregnancy, trauma, drug intoxication, cerebrovascular disease and metabolic causes including liver diseases were excluded from the study. Study revealed that majority of the study subjects were below 39 years (76%) of age and most of them were male (80%). Predominant cases were found to be pyogenic meningitis (44%), followed by encephalitis (32%), cerebral malaria (20%) and tubercular meningitis (4%). Neutrophilic leucocytosis, high cerebrospinal fluid protein, very high cell count and low sugar were a common observation in pyogenic meningitis while very high erythrocytic sedimentation rate was the main findings in tubercular meningitis and high lymphocytic count was observed in encephalitis as compared to other. So it is concluded that subjects suffering from fever with altered consciousness are 1. Predominantly male of young age group. 2. pyogenic meningitis is a predominant cause. 3. Cerebrospinal fluid findings were observed to have usual findings in disease of pyogenic meningitis, encephalitis and tubercular meningitis. doi: 10.3329/taj.v18i1.3300 TAJ 2005; 18(1): 25-29

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CLINICAL-EPIDEMIOLOGICAL CHARACTERISTICS OF ASEPTIC MENINGITIS IN CHILDREN OF KHMELNITSKYI REGION (PODILSKYI REGION, UKRAINE): FOURTEEN-YEAR EPIDEMIOLOGICAL OBSERVATION

Journal Infectology ◽

10.22625/2072-6732-2019-11-1-41-45 ◽

2019 ◽

Vol 11 (1) ◽

pp. 41-45

Author(s):

L. V. Pypa ◽

R. V. Svistilnik ◽

Yu. N. Lysytsia ◽

K. Yu. Romanchuk ◽

I. V. Odarchuk

Keyword(s):

Central Nervous System ◽

Cerebrospinal Fluid ◽

Nervous System ◽

Aseptic Meningitis ◽

Clinical Picture ◽

Epileptic Seizures ◽

Complete Recovery ◽

The Central Nervous System ◽

Meningitis In Children ◽

Epidemiological Characteristics

Aim of work – to analyze the etiological structure, epidemiological structure, social-demographic features and the nature of the development of complications of the central nervous system in aseptic meningitis in children in Khmelnitskyi region for the period 2004-2017.Materials and methods. It was conducted a prospective analysis of 208 cases of aseptic meningitis in children of whom 138 people were boys and 70 people were girls. The etiology of the disease was determined by studying cerebrospinal fluid using PCR method. Complications of the central nervous system were diagnosed on the basis of the clinical picture and CT or MRI scans. The analytical method was used to conduct the analysis of the received data.Results. The highest seasonal increase of the incidence was from August to October and it was 65.6% with its peak in September (24.0%). The clinical picture was characterized by a moderate trend in 71.2% of cases and in 28.8% by a severe course. In 100% of cases the disease began with a fever, headache (83.6%), vomiting (76.9%), abdominal pain with diarrhea (6.2%), epileptic seizures (0.9%). The average level of cytosis was 269.4±196.7 cells/mm3with a predominance of lymphocytes and the average protein level in cerebrospinal fluid was 73 ± 36 mg/dl. The etiological factor was established in 18 (8.6%) patients.Conclusions. Enterovirus remains to be the main pathogen which was determined in 72.2% of cases. The second place was taken by herpes viruses (22.2% of cases), the third place was given to the mumps virus (5.6% of cases) (in etiologically verified cases). In most cases the disease ended in complete recovery but in 47 (22.6%) patients the complications were observed. The prevalence of aseptic meningitis among children in Khmelnitskyi region was 6.2 per 100,000 children, and males outnumbered females by a 2:1 ratio.

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Normal Cerebrospinal Fluid Values

PEDIATRICS ◽

10.1542/peds.76.6.1023a ◽

1985 ◽

Vol 76 (6) ◽

pp. 1023-1024

Author(s):

MATTHEW J. CORY

Keyword(s):

Cerebrospinal Fluid ◽

Bacterial Meningitis ◽

Chart Review ◽

Febrile Child ◽

Cns Disease ◽

Csf Pleocytosis ◽

Meningitis In Children

To the Editor.— I read with interest the article, "Normal Cerebrospinal Fluid Values in Children: Another Look," by Portnoy and Olson (Pediatrics 1985;75:484-487). Their data certainly have relevance to the problem of interpretation of minimal pleocytosis discovered in the evaluation of the febrile child. Perhaps, because they excluded patients with CNS disease from chart review, they failed to find an additional useful piece of information, ie, the incidence of bacterial meningitis in children with the same or similar CSF pleocytosis.

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Interleukin 6 in Cerebrospinal Fluid of Patients with Meningitis is not a Useful Diagnostic Marker in the Differential Diagnosis of Meningitis

Annals of Clinical Biochemistry International Journal of Laboratory Medicine ◽

10.1177/000456329703400206 ◽

1997 ◽

Vol 34 (2) ◽

pp. 165-169 ◽

Cited By ~ 14

Author(s):

L F López-Cortés ◽

M Cruz-Ruiz ◽

J Gómez-Mateos ◽

D Jiménez-Hernández ◽

P Viciana-Fernández ◽

...

Keyword(s):

Central Nervous System ◽

Monoclonal Antibody ◽

Cerebrospinal Fluid ◽

Nervous System ◽

Differential Diagnosis ◽

Interleukin 6 ◽

Diagnostic Marker ◽

Neurological Diseases ◽

Central Nervous System Infections ◽

Pyogenic Meningitis

We assayed interleukin 6 (IL-6) concentrations in cerebrospinal fluid (CSF) from patients affected by meningitis of different aetiologies, and verified whether IL-6 can be used as a diagnostic marker in the differential diagnosis of meningitis. We used a monoclonal antibody enzyme immunoassay to test 98 CSF samples classified as pyogenic (15), viral (15), self-resolving aseptic meningitis (20), other infectious meningitis (9), neoplastic (4) and normal CSF from patients with (20) and without (15) non-infectious neurological diseases. CSF IL-6 concentrations were increased in pyogenic meningitis (100%) and in more than 50% of viral and other subarachnoid space infections, and rarely in patients without central nervous system infections. Though patients affected by pyogenic meningitis showed the highest levels of CSF IL-6, only a cut-off point ≥10000 pg/mL was able to discriminate pyogenic meningitis from those of other aetiologies with a specificity ≥94% and a positive predictive value of ≥0·75 but the sensitivity was ≤60%. Therefore, CSF IL-6 concentration is not a good diagnostic marker in the differential diagnosis of meningitis.

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Diagnostic Value of Clinical and Laboratory Findings in Childhood Meningitis

Journal of Pediatric Infectious Diseases ◽

10.1055/s-0039-3400960 ◽

2019 ◽

Vol 15 (02) ◽

pp. 079-085

Author(s):

Melike Emiroglu ◽

Recep Kesli ◽

Murat Kilicaslan

Keyword(s):

Cerebrospinal Fluid ◽

Statistical Analysis ◽

Bacterial Meningitis ◽

Diagnostic Value ◽

Human Enterovirus ◽

Study Patient ◽

Laboratory Findings ◽

Cell Counts ◽

Acute Meningitis ◽

Meningitis In Children

Abstract Objective Acute meningitis in childhood is a serious infectious disease that requires immediate medical assessment to ensure appropriate treatment and healthy outcomes. The aim of this retrospective study was to evaluate clinical and laboratory findings in the diagnosis of acute meningitis in children. Materials and Methods Between February 2011 and March 2013, 258 children aged between 1 month and 18 years who were admitted to Konya Training and Research Hospital, Turkey, with clinically suspected meningitis and undergoing lumbar puncture were enrolled in the study. Patient charts were reviewed using a standardized data collection tool. Fifty-nine patients were excluded because of incomplete data or because they did not meet the enrollment criteria. Further statistical analysis was conducted on the remaining 199 patients. The diagnostic values of clinical and laboratory findings for acute meningitis were investigated. IBM SPSS 21.0 for Windows was used for the statistical analysis. Results Of the 199 patients (61.3% male; median age: 24 months), 101 (50.8%) were diagnosed with meningitis. A definitive diagnosis of bacterial meningitis was made in 16 patients, while 5 patients had probable bacterial meningitis. In addition, 80 patients diagnosed as aseptic meningitis and 47 of these patients had human enterovirus meningitis. Headache was more common in patients with meningitis. In patients without meningitis, the most common complaints were seizures or seizures accompanied by fever. Erythrocyte sedimentation rates (ESR), levels of cerebrospinal fluid protein, and cell counts in cerebrospinal fluid examinations were higher in the meningitis group. C-reactive protein, ESR, and procalcitonin higher than 22.55 mg/L, 36.5 mm/hour, and 6.795 mg/mL, respectively, indicated bacterial meningitis. Conclusion Our results showed that a combination of clinical and laboratory markers could facilitate recognition of bacterial meningitis in children.

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OC 8277 IDENTIFICATION OF NEW CEREBROSPINAL FLUID AND BLOOD-BASED BIOMARKERS FOR THE DIAGNOSIS OF TUBERCULOUS MENINGITIS IN CHILDREN

BMJ Global Health ◽

10.1136/bmjgh-2019-edc.6 ◽

2019 ◽

Vol 4 (Suppl 3) ◽

pp. A3.2-A3

Author(s):

Masilo Charles Manyelo ◽

Regan S Solomons ◽

Gerhard Walzl ◽

Novel N Chegou

Keyword(s):

Cerebrospinal Fluid ◽

Tuberculous Meningitis ◽

Point Of Care ◽

Extrapulmonary Tuberculosis ◽

Diagnostic Delay ◽

Severe Form ◽

High Morbidity ◽

Serum Samples ◽

Meningitis In Children ◽

Study Participants

BackgroundTuberculous meningitis (TBM) is the most severe form of extrapulmonary tuberculosis (TB). It mostly affects young children and results in high morbidity and mortality, mainly due to diagnostic delay. There is an urgent need for new tests for the earlier and accurate diagnosis of the disease. We previously identified a 3-marker cerebrospinal fluid (CSF) biosignature (VEGF, IL-13, and LL-37) with potential to diagnose TBM. In the present study, we show that CSF and blood-based biosignatures may be useful in the diagnosis of TBM.MethodsCSF and serum samples were consecutively collected from 47 children that were admitted to the Tygerberg Academic Hospital in Cape Town, South Africa, on suspicion of having TBM. Using a multiplex platform, the concentrations of 69 host markers were evaluated in the CSF and serum samples from all the study participants, followed by statistical analysis to ascertain the usefulness of these biomarkers as diagnostic candidates for TBM disease.ResultsOut of the 47 study participants, 23 (48.9%) were finally diagnosed with TBM and 6 (12.8%) were infected with HIV. Several CSF and serum biomarkers showed potential individually as diagnostic candidates for TBM as ascertained by area under the receiver operator characteristics curve (AUC). However, the main findings of our study were the identification of a four-marker CSF biosignature which diagnosed TBM with an AUC of 0.97 (95% CI, 0.92–1.00), and a 3-marker serum biosignature which diagnosed TBM with an AUC of 0.84 (95% CI, 0.73–0.96). We also validated a previously identified 3-marker CSF biosignature (VEGF, IL13 and LL37) in the study.ConclusionCSF and serum biosignatures may be useful in the diagnosis of TBM in children. Our findings require further validation in larger, multi-site studies after which the biosignatures may be incorporated into point-of-care diagnostic tests for TBM.

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