Abstract
Objectives: cerebrospinal fluid (CSF) levels of interleukin (IL)-1 β and tumor necrosis factor (TNF) α were measured to assess the effect and application of dexamethasone (Dex) therapy for bacterial meningitis. Methods: associations between clinical findings and CSF parameters were first investigated, and prognosis was compared between 25 patients with Dex and 12 without Dex therapy. Results: patients with the presence of disturbed consciousness showed higher CSF levels of TNF α (mean: 3015 pg/ml) or protein (mean: 215 mg/dl) than those without it (both, P < 0.05). Simultaneous increase of TNF α (> 1000 pg/ml) and protein (> 100 mg/dl) was observed in 80% of patients with profoundly disturbed consciousness. Patients with Dex therapy presented higher TNF α/protein levels at diagnosis than those without Dex therapy (P < 0.05). Despite worse conditions at diagnosis, only one of 14 Dex-treated patients whose initial CSF TNF α levels exceeded 1000 pg/ml developed deafness. On the other hand, two of four patients without Dex therapy who had the same TNF α levels suffered from psychomotor retardation. The differences in the frequency of sequelae between those with and without Dex therapy were significant in patients showing high TNF α level (P < 0.05), but not in those showing high CSF levels of IL-1 β or protein. The logistic regression analysis indicated that high CSF protein level (P < 0.0001), or no Dex therapy (P = 0.0001) was the independent risk factor for sequelae. Conclusions: although the study number was small, our observations suggested that the neurologic severity, and implied that early Dex therapy might be beneficial for patients with prominently high TNF α levels.
| Original language | English |
|---|---|
| Pages (from-to) | 55-60 |
| Number of pages | 6 |
| Journal | Journal of Infection |
| Volume | 39 |
| Issue number | 1 |
| DOIs | |
| Publication status | Published - Jul 1999 |
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All Science Journal Classification (ASJC) codes
- Microbiology (medical)
- Infectious Diseases
Cite this
Cerebrospinal fluid cytokine levels and dexamethasone therapy in bacterial meningitis. / Ohga, Shouichi; Okada, Kenji; Ueda, Kohji; Takada, Hidetoshi; Ohta, Mitsuhiro; Aoki, Tomonobu; Kinukawa, Naoko; Miyazaki, Sumio; Hara, Toshiro.
In: Journal of Infection, Vol. 39, No. 1, 07.1999, p. 55-60.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Cerebrospinal fluid cytokine levels and dexamethasone therapy in bacterial meningitis
AU - Ohga, Shouichi
AU - Okada, Kenji
AU - Ueda, Kohji
AU - Takada, Hidetoshi
AU - Ohta, Mitsuhiro
AU - Aoki, Tomonobu
AU - Kinukawa, Naoko
AU - Miyazaki, Sumio
AU - Hara, Toshiro
PY - 1999/7
Y1 - 1999/7
N2 - Objectives: cerebrospinal fluid (CSF) levels of interleukin (IL)-1 β and tumor necrosis factor (TNF) α were measured to assess the effect and application of dexamethasone (Dex) therapy for bacterial meningitis. Methods: associations between clinical findings and CSF parameters were first investigated, and prognosis was compared between 25 patients with Dex and 12 without Dex therapy. Results: patients with the presence of disturbed consciousness showed higher CSF levels of TNF α (mean: 3015 pg/ml) or protein (mean: 215 mg/dl) than those without it (both, P < 0.05). Simultaneous increase of TNF α (> 1000 pg/ml) and protein (> 100 mg/dl) was observed in 80% of patients with profoundly disturbed consciousness. Patients with Dex therapy presented higher TNF α/protein levels at diagnosis than those without Dex therapy (P < 0.05). Despite worse conditions at diagnosis, only one of 14 Dex-treated patients whose initial CSF TNF α levels exceeded 1000 pg/ml developed deafness. On the other hand, two of four patients without Dex therapy who had the same TNF α levels suffered from psychomotor retardation. The differences in the frequency of sequelae between those with and without Dex therapy were significant in patients showing high TNF α level (P < 0.05), but not in those showing high CSF levels of IL-1 β or protein. The logistic regression analysis indicated that high CSF protein level (P < 0.0001), or no Dex therapy (P = 0.0001) was the independent risk factor for sequelae. Conclusions: although the study number was small, our observations suggested that the neurologic severity, and implied that early Dex therapy might be beneficial for patients with prominently high TNF α levels.
AB - Objectives: cerebrospinal fluid (CSF) levels of interleukin (IL)-1 β and tumor necrosis factor (TNF) α were measured to assess the effect and application of dexamethasone (Dex) therapy for bacterial meningitis. Methods: associations between clinical findings and CSF parameters were first investigated, and prognosis was compared between 25 patients with Dex and 12 without Dex therapy. Results: patients with the presence of disturbed consciousness showed higher CSF levels of TNF α (mean: 3015 pg/ml) or protein (mean: 215 mg/dl) than those without it (both, P < 0.05). Simultaneous increase of TNF α (> 1000 pg/ml) and protein (> 100 mg/dl) was observed in 80% of patients with profoundly disturbed consciousness. Patients with Dex therapy presented higher TNF α/protein levels at diagnosis than those without Dex therapy (P < 0.05). Despite worse conditions at diagnosis, only one of 14 Dex-treated patients whose initial CSF TNF α levels exceeded 1000 pg/ml developed deafness. On the other hand, two of four patients without Dex therapy who had the same TNF α levels suffered from psychomotor retardation. The differences in the frequency of sequelae between those with and without Dex therapy were significant in patients showing high TNF α level (P < 0.05), but not in those showing high CSF levels of IL-1 β or protein. The logistic regression analysis indicated that high CSF protein level (P < 0.0001), or no Dex therapy (P = 0.0001) was the independent risk factor for sequelae. Conclusions: although the study number was small, our observations suggested that the neurologic severity, and implied that early Dex therapy might be beneficial for patients with prominently high TNF α levels.
UR - http://www.scopus.com/inward/record.url?scp=0032821096&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0032821096&partnerID=8YFLogxK
U2 - 10.1016/S0163-4453(99)90103-2
DO - 10.1016/S0163-4453(99)90103-2
M3 - Article
C2 - 10468130
AN - SCOPUS:0032821096
VL - 39
SP - 55
EP - 60
JO - Journal of Infection
JF - Journal of Infection
SN - 0163-4453
IS - 1
ER -