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

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.

scholarly journals Evaluation of high sensitivity C-reactive protein assay in cerebrospinal fluid on the Dimension RxL analyzer

2012 ◽  
Vol 2 (1) ◽  
pp. 13-16
Author(s):  
Jozo Ćorić ◽  
Aleksandra Pašić ◽  
Mirsad Panjeta ◽  
Jasminka Mujić
Keyword(s):  
Cerebrospinal Fluid ◽  
Bacterial Meningitis ◽  
High Sensitivity ◽  
Acute Bacterial Meningitis ◽  
Control Group ◽  
C Reactive Protein ◽  
Protein Assay ◽  
Reactive Protein ◽  
The Mean ◽  
Low Sensitivity

Introduction: Low sensitivity and specificity in traditional laboratory tests became insufficient for accurate diagnostics and initiation of proper treatment of patients infected with bacterial meningitis. High sensitivity C reactive protein (hsCRP) may be an appropriate supplement for rapid diagnosis of bacterial meningitis. The subject of our investigation was the determination of C- reactive protein in cerebrospinal fluid (CSF) duringacute bacterial meningitis.Methods: HsCRP was analysed by a sensitive immunoturbidimetric assay using the Dimension RxL analyser (Siemens). Cerebrospinal fluid concentrations of C-reactive protein have been measured in 20 patients(age range,1 to 50 years) presenting with acute bacterial meningitis and also in a non-infected, non-inflamed control group (n=25).Results: The accuracy and precision of the method proved to be satisfactory. Repeatability of serial sampling for hsCRP described by coefficient of variation were CV=2.1-4.5%. This assay hsCRP in cerebrospinal fluid demonstrates adequate performance characteristics for routine clinical use. Elevated levels of CRP were found in 95% patients with bacterial meningitis. The mean CRP value in 25 uninfected control group was 0.25 mg/L (range 0.10-0.55). The mean CRP for patients with bacterial meningitis was 21.4 mg/L (range 0.40-100).Conclusions: A sensitive assay for CRP in CSF would be an useful adjunct to conventional investigation of acute infective meningitis.

Is cerebrospinal fluid lactate useful in differentiating scrub typhus meningitis from aseptic, bacterial and tuberculous meningitis?

2020 ◽  
pp. 004947552097595
Author(s):  
Shalabh Arora ◽  
Kundavaram Paul Prabhakar Abhilash ◽  
Shubhanker Mitra ◽  
Darpanarayan Hazra ◽  
Karthik Gunasekharan ◽  
...  
Keyword(s):  
Cerebrospinal Fluid ◽  
Bacterial Meningitis ◽  
Clinical Features ◽  
Aseptic Meningitis ◽  
Scrub Typhus ◽  
Indian Subcontinent ◽  
Cross Sectional Study ◽  
Neck Stiffness ◽  
Cross Sectional ◽  
Reported Data

Scrub typhus is one of the most common causes of meningo-encephalitis in endemic areas of the Indian subcontinent. Numerous studies have established the reliability of cerebrospinal fluid lactate for differentiation of bacterial meningitis from aseptic meningitis. However, there are no reported data on the predictive value of cerebrospinal fluid lactate in scrub typhus meningitis. We thus conducted a cross-sectional study to examine the diagnostic accuracy of cerebrospinal fluid lactate in the differentiation of different causes of acute meningitis. Over two years, we studied 119 patients, with almost equal gender distribution, whose mean age was 43.58 (±18) years and their overall mean duration of fever was 11.7 (±21.0) days. Commonest clinical features overall were neck stiffness; values of cerebrospinal fluid lactate were lowest in aseptic meningitis, followed by scrub typhus, TB and bacterial meningitis. We conclude that cerebrospinal fluid lactate levels may be a useful adjunct to clinical features and laboratory investigations to differentiate between bacterial, viral, tubercular and scrub meningitis.

scholarly journals The cerebrospinal fluid changes and clinical characteristics of aseptic meningitis in Kawasaki disease

2020 ◽  
Author(s):  
Fan Hu ◽  
Xiaoqing Shi ◽  
Yang Fan ◽  
Hanmin Liu ◽  
Kaiyu Zhou
Keyword(s):  
Cerebrospinal Fluid ◽  
Kawasaki Disease ◽  
Aseptic Meningitis ◽  
Clinical Symptoms ◽  
Clinical Signs ◽  
Cervical Lymphadenopathy ◽  
C Reactive Protein ◽  
Neck Stiffness ◽  
Reactive Protein ◽  
Significant Difference

Abstract Background: Aseptic meningitis is not a common feature in Kawasaki disease (KD). However, it could cause difficulty in making correct and in-time diagnosis Methods: We retrospectively investigated patients of KD and bacterial meningitis (BM). Totally 38 KD patients and 126 BM patients were brought into this study. Clinical symptoms, signs and laboratory examinations were compared between the two groups, which included: duration of fever before lumbar puncture, conjunctiva injection, oral cavity change, rash, cervical lymphadenopathy and extremities change, vomiting, front fontanel bulging, neck stiffness, leukocytes, hemoglobin, platelets, C-reactive protein, cerebrospinal fluid examinations, liver function and urinalysis. Results: In clinical signs, vomit and neck stiffness were more prevalent in BM. KD patients showed higher blood leukocyte (p<0.001) and C-reactive protein (p<0.001) in the early febrile stage. Glucose in cerebrospinal fluid of BM patients was significantly lower than KD patients (p=0.003). In ROC curve, the optimal cutoff value of CSF glucose was 2.945mmol/L with the sensitivity of 84.2% and specificity of 71.4%. Pyuria was more prevalent in KD patients (p<0.001). There was no significant difference in front fontanel bulging, hemoglobin, platelet, alanine transaminase, aspartate transaminase, albumin, cerebrospinal fluid leukocytes, cerebrospinal fluid protein and cerebrospinal fluid lactate dehydrogenase. Conclusions ： Full investigation of clinical manifestation and laboratory tests is necessary to distinguish KD with aseptic meningitis and BM. In CSF study, glucose level is more efficient than other items to distinguish these two diseases. Decreased CSF glucose is possibly an indicator of BM rather than KD.

scholarly journals The combination of cerebrospinal fluid procalcitonin, lactate, interleukin-8 and interleukin-10 concentrations for the diagnosis of postneurosurgical bacterial meningitis: A prospective study

2018 ◽  
Vol 56 (1) ◽  
pp. 133-140 ◽  
Author(s):  
Guojun Zhang ◽  
Chunjiao Yang ◽  
Xixiong Kang ◽  
Zhixian Gao ◽  
Hong Wan ◽  
...  
Keyword(s):  
Cerebrospinal Fluid ◽  
Bacterial Meningitis ◽  
Receiver Operating Characteristic ◽  
Aseptic Meningitis ◽  
Operating Characteristic ◽  
Interleukin 10 ◽  
Interleukin 8 ◽  
Receiver Operating Characteristic Curves ◽  
Marker Test ◽  
Receiver Operating

Background The differential diagnosis between postneurosurgical bacterial meningitis and aseptic meningitis remains challenging both for the clinician and the laboratory. Combinations of markers, as opposed to single ones, may improve diagnosis and thereby survival. Methods This prospective cohort study included patients with suspected bacterial meningitis after neurosurgery. The patients were divided into two groups according to the diagnostic criteria of meningitis involving a postneurosurgical bacterial meningitis group and a postneurosurgical aseptic meningitis group. Four biomarkers, including cerebrospinal fluid procalcitonin, lactate, interleukin-8 and interleukin-10 were assayed separately, and three algorithms were constructed using a linear combination. The area under the receiver operating characteristic curve was used to compare their performances. Results A cohort of 112 patients was enrolled in our study. Forty-three patients were diagnosed with postneurosurgical bacterial meningitis, and the cerebrospinal fluid values of their biomarkers were higher in patients with postneurosurgical bacterial meningitis than with postneurosurgical aseptic meningitis. The area under the receiver operating characteristic curves for the detection of postneurosurgical bacterial meningitis were 0.803 (95% confidence interval [CI], 0.724–0.883) for procalcitonin; 0.936 (95% CI, 0.895–0.977) for lactate; 0.771 (95% CI, 0.683–0.860) for interleukin-8; 0.860 (95% CI, 0.797–0.929) for interleukin-10; 0.937 (95% CI, 0.897–0.977) for the composite two-marker test; 0.945 (95% CI, 0.908–0.982) for the composite three-marker test and 0.954 (95% CI, 0.922–0.989) for the composite of all tests. The area under the receiver operating characteristic curves of the combination tests were greater than those of the single markers. Conclusions Combining information from several markers improved the diagnostic accuracy in detecting postneurosurgical bacterial meningitis.

ACUTE BACTERIAL MENINGITIS IN CHILDREN

PEDIATRICS ◽  
1960 ◽  
Vol 25 (5) ◽  
pp. 742-747
Author(s):  
Robert J. Haggerty ◽  
Mohsen Ziai
Keyword(s):  
Clinical Study ◽  
Bacterial Meningitis ◽  
Etiologic Agent ◽  
Acute Bacterial Meningitis ◽  
Controlled Study ◽  
Antimicrobial Drugs ◽  
Significant Difference ◽  
Meningitis In Children ◽  
Multiple Drugs

A controlled study of the treatment of bacterial meningitis with single and multiple, potentially antagonistic antimicrobial drugs was undertaken. Sixty-five patients received a single and 71 received several drugs in combination. The two groups were generally comparable. There was no significant difference in the results: that is antagonism could not be demonstrated in this clinical study. It seems reasonable to recommend that, in patients over 1 month of age with acute primary bacterial meningitis in whom an etiologic agent cannot be promptly identified, the use of multiple drugs aimed at the three most likely organisms (pneumococcus, meningococcus, H. influenzae) can be employed without danger of clinically apparent antagonism.

scholarly journals Levofloxacin Disposition in Cerebrospinal Fluid in Patients with External Ventriculostomy

2003 ◽  
Vol 47 (10) ◽  
pp. 3104-3108 ◽  
Author(s):  
Federico Pea ◽  
Federica Pavan ◽  
Ennio Nascimben ◽  
Claudio Benetton ◽  
Pier Giorgio Scotton ◽  
...  
Keyword(s):  
Cerebrospinal Fluid ◽  
Steady State ◽  
Bacterial Meningitis ◽  
Acute Bacterial Meningitis ◽  
Terminal Phase ◽  
Communicating Hydrocephalus ◽  
Synergistic Activity ◽  
Dosing Interval ◽  
Concentration Time ◽  
Meningeal Inflammation

ABSTRACT In vitro levofloxacin exhibits both potent or intermediate activity against most of the pathogens frequently responsible for acute bacterial meningitis and synergistic activity with some beta-lactams. Since levofloxacin was shown to penetrate the cerebrospinal fluid (CSF) during meningeal inflammation both in animals and in humans, the disposition of levofloxacin in CSF was studied in 10 inpatients with external ventriculostomy because of communicating hydrocephalus related to subarachnoid occlusion due to cerebral accidents who were treated with 500 mg of levofloxacin intravenously twice a day because of extracerebral infections. Plasma and CSF concentration-time profiles and pharmacokinetics were assessed at steady state. Plasma and CSF levofloxacin concentrations were analyzed by high-pressure liquid chromatography. The peak concentration of levofloxacin at steady state (C max ss)was 10.45 mg/liter in plasma and 4.06 mg/liter in CSF, respectively, with the ratio of the C max ss in CSF to the C max ss in plasma being 0.47. The areas under the concentration-time curves during the 12-h dosing interval (AUC0-τs) were 47.69 mg · h/liter for plasma and 33.42 mg · h/liter for CSF, with the ratio of the AUC0-τ for CSF to the AUC0-τ for plasma being 0.71. The terminal-phase half-life of levofloxacin in CSF was longer than that in plasma (7.02 ± 1.57 and 5.51 ± 1.36 h, respectively; P = 0.034). The ratio of the levofloxacin concentration in CSF to the concentration in plasma progressively increased with time, from 0.30 immediately after dosing to 0.99 at the end of the dosing interval. In the ventricular CSF of patients with uninflamed meninges, levofloxacin was shown to provide optimal exposure, which approximately corresponded to the level of exposure of the unbound drug in plasma. The findings provide support for trials of levofloxacin with twice-daily dosing in combination with a reference beta-lactam for the treatment of bacterial meningitis in adults. This cotreatment could be useful both for overcoming Streptococcus pneumoniae resistance and for enabling optimal exposure of the CSF to at least one antibacterial agent for the overall treatment period.

Cerebrospinal Fluid Leucine-Rich Alpha-2 Glycoprotein (LRG) Levels in Children with Acute Bacterial Meningitis

2021 ◽  
Author(s):  
Kushal Talukder ◽  
Rajniti Prasad ◽  
Abhisek Abhinay ◽  
Ankur Singh ◽  
Ragini Srivastava ◽  
...  
Keyword(s):  
Cerebrospinal Fluid ◽  
Bacterial Meningitis ◽  
Acute Bacterial Meningitis
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