Acute meningitis prognosis using cerebrospinal fluid interleukin-6 levels |
| |
Authors: | Vázquez Jorge Alejandro Adducci Maria del Carmen Coll Carlos Monzón Daniel Godoy Iserson Kenneth V |
| |
Affiliation: | Emergency Department, Hospital Italiano de San Justo, Buenos Aires, Argentina. |
| |
Abstract: | BackgroundImproved diagnostic tests would aid in diagnosing and treating community-acquired meningitis.ObjectiveTo analyze the diagnostic value of interleukin-6 (IL-6) in the cerebrospinal fluid (CSF) of patients presenting with symptoms of acute meningitis.Material and MethodsIn a 6-month prospective, observational, cross-sectional emergency department (ED) study, serum and CSF samples were obtained from all patients with a headache and fever in whom the physician suspected meningitis. Patients were excluded if computed tomography findings contraindicated a lumbar puncture, if they had bleeding disorders, or if their serum indicated bleeding. IL-6 levels were measured and compared in patients with (Group A) and without (Group B) bacterial meningitis.ResultsSamples were obtained from 53 patients, of whom 40 were ultimately found to have meningitis. These 40 patients averaged 49.6 ± 21.9 years, with number of men 18 (45%), hospitalizations 21 (52%), mortality 3 (.07%), and IL-6 average rating 491 (median: 14.5; range 0000–6000). Findings in the two groups were: Group A (with meningitis): n = 13, average IL-6 level: 1495 (median: 604; 25/75 percentiles: 232.5–2030; 95% confidence interval [CI] 371.7–2618.6; range 64–6000). Group B (with aseptic meningitis): n = 27, average IL-6 level: 7.34 (median: 5; 25/75 percentiles: 0.0/15.1; 95% CI 3.94–10.73; range 0–23.6). Mann-Whitney rank sum test: p < 0.0001.ConclusionsIn patients with acute bacterial meningitis, CSF cytokine concentrations are elevated. Measuring CSF inflammatory cytokine levels in patients with acute meningitis could be a valuable ED diagnostic tool. Using this tool could improve the prognosis of patients with bacterial meningitis by allowing more rapid initiation of antibiotic treatment. |
| |
Keywords: | meningitis interleukin-6 prognosis bacterial acute cerebrospinal fluid |
本文献已被 ScienceDirect PubMed 等数据库收录! |
|