Raised Proinflammatory Cytokine Production Within Cerebrospinal Fluid Precedes Fever Onset in Patients With Neurosurgery-Associated Bacterial Meningitis*

Abstract

The present study suggests that raised cerebrospinal fluid tumor necrosis factor -α, interleukin-1β, and interleukin-8 in a temporal manner may indicate early bacterial meningitis development in neurosurgical patients, enabling earlier diagnostic certainty and improved patient outcomes.

Significance of cerebrospinal fluid inflammatory markers for diagnosing external ventricular drain–associated ventriculitis in patients with severe traumatic brain injury

“…One study investigated the role of IL-6 in CSF for predicting postoperative EVD-associated ventriculitis after neurosurgical procedures. 17 IL-6 in CSF was significantly increased in patients with ventriculitis, and it had a moderate diagnostic potential for diagnosing ventriculitis on the day of fever rise. The calculated optimal cutoff value was similar to ours.…”

“…Currently, CSF culture remains the gold standard for diagnosing bacterial meningitis and is positive in 70%-85% of cases prior to antibiotic administration. 2,17 However, patients with TBI and an EVD frequently receive periprocedural antibiotic prophylaxis, thereby reducing the diagnostic value of microbiological CSF samples. 14,17 Moreover, in the early phase after severe TBI, patients are severely ill and need antibiotic treatment for various indications (e.g., infections of the lung, urinary tract infections, sepsis), which may further reduce the diagnostic value of microbiological CSF samples.…”

“…2,17 However, patients with TBI and an EVD frequently receive periprocedural antibiotic prophylaxis, thereby reducing the diagnostic value of microbiological CSF samples. 14,17 Moreover, in the early phase after severe TBI, patients are severely ill and need antibiotic treatment for various indications (e.g., infections of the lung, urinary tract infections, sepsis), which may further reduce the diagnostic value of microbiological CSF samples. 15 In addition, it takes at least 48 hours for routine CSF cultures to yield results, limiting their clinical use acutely.…”

“…15 In addition, it takes at least 48 hours for routine CSF cultures to yield results, limiting their clinical use acutely. 17 Here, we sought to identify the diagnostic potential of routine inflammatory markers in CSF and serum for early detection of ventriculitis after TBI and EVD implantation. We presented ROC curves and thresholds of common serum and CSF biomarkers on the day of onset of EVD-associated ventriculitis compared with noninfectious controls, which can support clinical decisionmaking.…”

Padronização de teste molecular para o diagnóstico de meningites bacterianas pós-neurocirurgia

“…Estudos utilizam a cultura negativa do LCR como confirmação de uma meningite não bacteriana ou asséptica (Ramos-Martínez et al, 2009;Liu et al, 2014;Liu et al, 2015). A British Society for Antimicrobial Chemotherapy sugere que antibióticos empíricos introduzidos em pacientes com suspeita de meningite pós-operatória podem ser removidos com segurança entre 48h e 72h após uma cultura negativa (Zarrouk et al, 2007) (Patel et al, 2012).…”