Document Detail


Acute meningitis prognosis using cerebrospinal fluid interleukin-6 levels.
MedLine Citation:
PMID:  22142673     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Improved diagnostic tests would aid in diagnosing and treating community-acquired meningitis.
OBJECTIVE: To analyze the diagnostic value of interleukin-6 (IL-6) in the cerebrospinal fluid (CSF) of patients presenting with symptoms of acute meningitis.
MATERIAL AND METHODS: In 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.
RESULTS: Samples 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.
CONCLUSIONS: In 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.
Authors:
Jorge Alejandro Vázquez; Maria del Carmen Adducci; Carlos Coll; Daniel Godoy Monzón; Kenneth V Iserson
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Publication Detail:
Type:  Journal Article     Date:  2011-12-03
Journal Detail:
Title:  The Journal of emergency medicine     Volume:  43     ISSN:  0736-4679     ISO Abbreviation:  J Emerg Med     Publication Date:  2012 Aug 
Date Detail:
Created Date:  2012-08-13     Completed Date:  2013-02-14     Revised Date:  2013-03-21    
Medline Journal Info:
Nlm Unique ID:  8412174     Medline TA:  J Emerg Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  322-7     Citation Subset:  IM    
Copyright Information:
Copyright © 2012 Elsevier Inc. All rights reserved.
Affiliation:
Emergency Department, Hospital Italiano de San Justo, Buenos Aires, Argentina.
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MeSH Terms
Descriptor/Qualifier:
Acute Disease
Adolescent
Adult
Aged
Cross-Sectional Studies
Emergency Service, Hospital
Female
Fever / etiology
Headache / etiology
Hospitalization
Humans
Interleukin-6 / cerebrospinal fluid*
Male
Meningitis, Aseptic / cerebrospinal fluid*,  diagnosis*
Meningitis, Bacterial / cerebrospinal fluid*,  diagnosis*
Meningitis, Haemophilus / cerebrospinal fluid,  diagnosis
Meningitis, Listeria / cerebrospinal fluid,  diagnosis
Meningitis, Meningococcal / cerebrospinal fluid,  diagnosis
Meningitis, Pneumococcal / cerebrospinal fluid,  diagnosis
Middle Aged
Predictive Value of Tests
Prognosis
Prospective Studies
Statistics, Nonparametric
Young Adult
Chemical
Reg. No./Substance:
0/Interleukin-6

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