IL-6 and IL-8 in cerebrospinal fluid from patients with aseptic meningitis and bacterial meningitis: their potential role as a marker for differential diagnosis

Abstract Cerebrospinal fluid (CSF) neopterin been previously reported in various diseases. In this study CSF neopterin, biopterin, and nitrite/nitrate (NOx) Contents were measured and the correlation between them in child patients with various kinds of neurological diseases were investigated. Changes in the CSF neopterin levels in patients with bacterial meningitis were similar to those previously reported for those with bacterial meningitis; on the 2th hospital day they were significantly higher than on admission, and on the 6th hospital day they were tapered. The CSF biopterin levels and CSF NOx content in patients with bacterial meningitis on admission were significantly higher than those with other categories and were decreased gradually. Although patients with high levels of CSF neopterin tended to have high CSF biopterin levels in any categories, there was no significant correlation between CSF neopterin and biopterin levels. The CSF biopterin and NOx levels in patients with convulsions were higher than those with aseptic meningitis. Since the neuro-protective or anticonvulsant role for NO was previously reported, high CSF biopterin and NOx levels in patients having epilepsy or febrile convulsions may be regarded as one of the endogenous mechanisms for recovery from an overexcitatory brain in patients with convulsive diseases.

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The Potential Role of Matrix Metalloproteinases 8 and 9 and Myeloperoxidase in Predicting Outcomes of Bacterial Meningitis of Childhood

Mediators of Inflammation ◽

10.1155/2019/7436932 ◽

2019 ◽

Vol 2019 ◽

pp. 1-8 ◽

Cited By ~ 4

Author(s):

Okko Savonius ◽

Irmeli Roine ◽

Saeed Alassiri ◽

Taina Tervahartiala ◽

Otto Helve ◽

...

Keyword(s):

Clinical Trial ◽

Cerebrospinal Fluid ◽

Matrix Metalloproteinases ◽

Bacterial Meningitis ◽

Confidence Interval ◽

Potential Role ◽

Tissue Inhibitor Of Metalloproteinase ◽

Inflammatory Cascade ◽

Disease Outcomes

Background. Matrix metalloproteinases (MMPs) and myeloperoxidase (MPO) contribute to the inflammatory cascade in the cerebrospinal fluid (CSF) during bacterial meningitis. We determined levels of MPO, MMP-8, MMP-9, and tissue inhibitor of metalloproteinase- (TIMP-) 1 in the CSF of children with bacterial meningitis and investigated how these inflammatory mediators relate to each other and to the disease outcomes. Methods. Clinical data and the diagnostic CSF samples from 245 children (median age eight months) with bacterial meningitis were obtained from a clinical trial in Latin America in 1996–2003. MMP-9 levels in the CSF were assessed by zymography, while MMP-8, MPO, and TIMP-1 concentrations were determined with immunofluorometric and enzyme-linked immunosorbent assays. Results. MPO correlated positively with MMP-8 (rho 0.496, P<0.001) and MMP-9 (rho 0.153, P=0.02) but negatively with TIMP-1 (rho -0.361, P<0.001). MMP-8 emerged as the best predictor of disease outcomes: a CSF MMP-8 concentration above the median increased the odds of death 4.9-fold (95% confidence interval 1.8–12.9). Conclusions. CSF MMP-8 presented as an attractive prognostic marker in children with bacterial meningitis.

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Comparison of enterovirus detection in cerebrospinal fluid with Bacterial Meningitis Score in children

Einstein (São Paulo) ◽

10.1590/s1679-45082017ao3880 ◽

2017 ◽

Vol 15 (2) ◽

pp. 167-172 ◽

Cited By ~ 4

Author(s):

Frederico Ribeiro Pires ◽

Andréia Christine Bonotto Farias Franco ◽

Alfredo Elias Gilio ◽

Eduardo Juan Troster

Keyword(s):

Cerebrospinal Fluid ◽

Bacterial Meningitis ◽

Aseptic Meningitis ◽

Medical Records ◽

Pediatric Patients ◽

Tertiary Hospital ◽

Viral Meningitis ◽

Parenteral Antibiotic ◽

Score Analysis

ABSTRACT Objective To measure the role of enterovirus detection in cerebrospinal fluid compared with the Bacterial Meningitis Score in children with meningitis. Methods A retrospective cohort based on analysis of medical records of pediatric patients diagnosed as meningitis, seen at a private and tertiary hospital in São Paulo, Brazil, between 2011 and 2014. Excluded were patients with critical illness, purpura, ventricular shunt or recent neurosurgery, immunosuppression, concomitant bacterial infection requiring parenteral antibiotic therapy, and those who received antibiotics 72 hours before lumbar puncture. Results The study included 503 patients. Sixty-four patients were excluded and 94 were not submitted to all tests for analysis. Of the remaining 345 patients, 7 were in the Bacterial Meningitis Group and 338 in the Aseptic Meningitis Group. There was no statistical difference between the groups. In the Bacterial Meningitis Score analysis, of the 338 patients with possible aseptic meningitis (negative cultures), 121 of them had one or more points in the Bacterial Meningitis Score, with sensitivity of 100%, specificity of 64.2%, and negative predictive value of 100%. Of the 121 patients with positive Bacterial Meningitis Score, 71% (86 patients) had a positive enterovirus detection in cerebrospinal fluid. Conclusion Enterovirus detection in cerebrospinal fluid was effective to differentiate bacterial from viral meningitis. When the test was analyzed together with the Bacterial Meningitis Score, specificity was higher when compared to Bacterial Meningitis Score alone.

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Evaluation of IL-8 level in cerebrospinal fluid in acute bacterial meningitis in adults

Medical Journal of Tabriz University of Medical Sciences and Health Services ◽

10.34172/mj.2021.003 ◽

2021 ◽

Vol 42 (6) ◽

pp. 634-641

Author(s):

Zhinous Bayat-Makoo ◽

Puran Karimi ◽

Negar Mohtadi

Keyword(s):

Cerebrospinal Fluid ◽

Bacterial Meningitis ◽

Aseptic Meningitis ◽

High Sensitivity ◽

Interleukin 8 ◽

Acute Bacterial Meningitis ◽

Neck Stiffness ◽

Significant Difference ◽

Level Of Consciousness ◽

Consciousness Disorder

Background: Interleukin 8 increases in various types of meningitis, specifically acute bacterial meningitis inflammation, and it is important in the distinction between types of meningitis. The present paper aims at evaluation of the level of interleukin 8 in cerebrospinal fluid in acute adult bacterial meningitis. Methods: All adult patients’ with diagnosis of suspected meningitis with symptoms of fever, headache, neck stiffness, and consciousness disorder. Lumbar puncture was taken in between the third and fourth vertebra by a specialist physician for all patients suspected with meningitis. To determine the level of consciousness, the GCS of the patients was determined and the cerebrospinal fluid was cultured and sent to the laboratory for the analyses of cell count, diffraction, CSF fluid glucose, CSF fluid protein, LDH, or lactate dehydrogenase, and the level of interleukin 8. Results: The mean of IL-8 protein was 296.17±48.57Pg/ml in patients with aseptic meningitis and 1088.96±526.55Pg/ml in the group of patients with septic meningitis. There was a significant difference between the two groups in terms of the amount of interleukin 8 (p = 0.009). Cutoff was 297.6 Pg/ml for the detection of positive bacterial meningitis with a sensitivity of 92% and the specificity of 83.1% was 297.6 pg/ml. Conclusion: Interleukin 8 has a high sensitivity and specificity in the diagnosis of bacterial meningitis from aseptic meningitis, and along with the measurement of cerebrospinal fluid protein, it can be a good criterion for differentiation of bacterial from aseptic meningitis.

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The differential diagnosis of bacterial and aseptic meningitis using cerebrospinal fluid laboratory tests

Infection ◽

10.1007/bf01641290 ◽

1983 ◽

Vol 11 (3) ◽

pp. 129-131 ◽

Cited By ~ 21

Author(s):

A. Pönkä ◽

K. Ojala ◽

A. M. Teppo ◽

Th. H. Weber

Keyword(s):

Cerebrospinal Fluid ◽

Differential Diagnosis ◽

Aseptic Meningitis ◽

Laboratory Tests

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The Use of S100B and Tau Protein Concentrations in the Cerebrospinal Fluid for the Differential Diagnosis of Bacterial Meningitis: A Retrospective Analysis

European Neurology ◽

10.1159/000330566 ◽

2011 ◽

Vol 66 (3) ◽

pp. 128-132 ◽

Cited By ~ 6

Author(s):

Klaus Jung ◽

Christoph Goerdt ◽

Peter Lange ◽

Joachim Blocher ◽

Marija Djukic ◽

...

Keyword(s):

Cerebrospinal Fluid ◽

Differential Diagnosis ◽

Bacterial Meningitis ◽

Retrospective Analysis ◽

Tau Protein

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The diagnostic value of cerebrospinal fluids procalcitonin and lactate for the differential diagnosis of post-neurosurgical bacterial meningitis and aseptic meningitis

Clinical Biochemistry ◽

10.1016/j.clinbiochem.2014.10.007 ◽

2015 ◽

Vol 48 (1-2) ◽

pp. 50-54 ◽

Cited By ~ 31

Author(s):

Youran Li ◽

Guojun Zhang ◽

Ruimin Ma ◽

Yamei Du ◽

Limin Zhang ◽

...

Keyword(s):

Differential Diagnosis ◽

Bacterial Meningitis ◽

Aseptic Meningitis ◽

Diagnostic Value

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Cerebrospinal fluid lactate as a marker to differentiate between community-acquired acute bacterial meningitis and aseptic meningitis/encephalitis in adults: a Danish prospective observational cohort study

Infectious Diseases ◽

10.1080/23744235.2018.1441539 ◽

2018 ◽

Vol 50 (7) ◽

pp. 514-521 ◽

Cited By ~ 7

Author(s):

Kristian Buch ◽

Jacob Bodilsen ◽

Andreas Knudsen ◽

Lykke Larsen ◽

Jannik Helweg-Larsen ◽

...

Keyword(s):

Cerebrospinal Fluid ◽

Cohort Study ◽

Bacterial Meningitis ◽

Aseptic Meningitis ◽

Observational Cohort Study ◽

Acute Bacterial Meningitis ◽

Prospective Observational Cohort Study ◽

Observational Cohort

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Point-of-care Cerebrospinal Fluid Gram Stain For the Management of Acute Meningitis in Adults: A Retrospective Observational Study

10.21203/rs.3.rs-94435/v1 ◽

2020 ◽

Author(s):

Tomohiro Taniguchi ◽

Sanefumi Tsuha ◽

Soichi Shiiki ◽

Masashi Narita

Keyword(s):

Cerebrospinal Fluid ◽

Bacterial Meningitis ◽

Observational Study ◽

Aseptic Meningitis ◽

Point Of Care ◽

Laboratory Data ◽

Retrospective Observational Study ◽

Antibiotic Administration ◽

Gram Stain ◽

Acute Meningitis

Abstract Background: Gram staining of cerebrospinal fluid (CSF) is widely used in the diagnosis of acute meningitis, but is often conducted in the laboratory, as only some hospitals have access to point-of-care Gram stain (PCGS). The purpose of this study was to demonstrate the clinical impact and utility of PCGS in diagnosing and treating both bacterial and aseptic meningitis in adults. Methods: This was a hospital-based, retrospective observational study at a referral center in Okinawa, Japan. We reviewed the records of all patients aged 15 years or older who were admitted to the Division of Infectious Diseases between 1995 and 2015 and finally diagnosed with bacterial (n=34) or aseptic meningitis (n=97). For bacterial meningitis, we compared the treatments that were actually selected based on PCGS with simulated treatments that would have been based on the Japanese guidelines. For aseptic meningitis, we compared the rates of antibiotic use between real cases where PCGS was available and real cases where it was not. Results: PCGS was the most precise predictor for differentiating between bacterial and aseptic meningitis (sensitivity 91.2%, specificity 98.9%), being superior in this regard to medical histories, vital signs and physical examinations, and laboratory data available in the emergency room. In bacterial meningitis, PCGS reduced the frequency of meropenem use (1/34=3.0%) compared with simulated cases in which PCGS was not available (19/34=55.9%) (p=0.000). In real aseptic meningitis cases, the rate of antibiotic administration was lower when PCGS was used (38/97=39.2%) than when it was not (45/74=60.8%) (p=0.006). Conclusions: PCGS of CSF distinguishes between bacterial and aseptic meningitis more accurately than other predictors available in the ER. Patients are more likely to receive narrower-spectrum antimicrobials when PCGS is used than when it is not. PCGS of CSF thus can potentially suppress the empiric use of antimicrobials for aseptic meningitis.

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