Cerebrospinal Fluid Cell Counts and Chemistries in Bacterial Meningitis

Ce, Arevalo; Pf, Barnes; Duda, Matthew; Jm, Leedom

doi:10.1097/00007611-198909000-00016

Cited by 23 publications

(6 citation statements)

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“…The CSF protein concentration increases and the protein and ion composition changes dramatically, both mainly due to the breakdown of the blood-CSF barrier. In addition, glucose levels can go down as low as zero [40, 41]. The dynamics and complexity of these CSF alterations can hardly be mimicked under in vitro conditions, underlining the need of in vivo investigations.…”

Section: Discussionmentioning

confidence: 99%

In vivo proteomics identifies the competence regulon and AliB oligopeptide transporter as pathogenic factors in pneumococcal meningitis

et al. 2019

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Streptococcus pneumoniae (pneumococci) is a leading cause of severe bacterial meningitis in many countries worldwide. To characterize the repertoire of fitness and virulence factors predominantly expressed during meningitis we performed niche-specific analysis of the in vivo proteome in a mouse meningitis model, in which bacteria are directly inoculated into the cerebrospinal fluid (CSF) cisterna magna. We generated a comprehensive mass spectrometry (MS) spectra library enabling bacterial proteome analysis even in the presence of eukaryotic proteins. We recovered 200,000 pneumococci from CSF obtained from meningitis mice and by MS we identified 685 pneumococci proteins in samples from in vitro filter controls and 249 in CSF isolates. Strikingly, the regulatory two-component system ComDE and substrate-binding protein AliB of the oligopeptide transporter system were exclusively detected in pneumococci recovered from the CSF. In the mouse meningitis model, AliB-, ComDE-, or AliB-ComDE-deficiency resulted in attenuated meningeal inflammation and disease severity when compared to wild-type pneumococci indicating the crucial role of ComDE and AliB in pneumococcal meningitis. In conclusion, we show here mechanisms of pneumococcal adaptation to a defined host compartment by a proteome-based approach. Further, this study provides the basis of a promising strategy for the identification of protein antigens critical for invasive disease caused by pneumococci and other meningeal pathogens.

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Section: Discussionmentioning

confidence: 99%

In vivo proteomics identifies the competence regulon and AliB oligopeptide transporter as pathogenic factors in pneumococcal meningitis

et al. 2019

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“…listeria or partially treated bacterial meningitis. 101 A predominance of neutrophils may also be seen in early viral meningitis, 102 especially enteroviral disease, although such patients are unlikely to have a total CSF white cell count of over 2000 cells per mm 3 . 81…”

Section: Csf Cell Countmentioning

confidence: 99%

The UK joint specialist societies guideline on the diagnosis and management of acute meningitis and meningococcal sepsis in immunocompetent adults

McGill

Heyderman

Michael

et al. 2016

Journal of Infection

153

167

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Bacterial meningitis and meningococcal sepsis are rare conditions with high case fatality rates. Early recognition and prompt treatment saves lives. In 1999 the British Infection Society produced a consensus statement for the management of immunocompetent adults with meningitis and meningococcal sepsis. Since 1999 there have been many changes. We therefore set out to produce revised guidelines which provide a standardised evidence-based approach to the management of acute community acquired meningitis and meningococcal sepsis in adults. A working party consisting of infectious diseases physicians, neurologists, acute physicians, intensivists, microbiologists, public health experts and patient group representatives was formed. Key questions were identified and the literature reviewed. All recommendations were graded and agreed upon by the working party. The guidelines, which for the first time include viral meningitis, are written in accordance with the AGREE 2 tool and recommendations graded according to the GRADE system. Main changes from the original statement include the indications for pre-hospital antibiotics, timing of the lumbar puncture and the indications for neuroimaging. The list of investigations has been updated and more emphasis is placed on molecular diagnosis. Approaches to both antibiotic and steroid therapy have been revised. Several recommendations have been given regarding the follow-up of patients.

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“…Although bacterial meningitis could be separated statistically by means of the Fn index from all other disorders, its quantification probably does not add to the value of lactate determination which appears to be the most reliable CSF parameter for the differential diagnosis of CNS infection (25,26,27). Like lactate, CSF Fn will not be useful for the differentiation of bacterial and carcinomatous meningitis where cytology remains the single most valuable laboratory test (28).…”

Section: Fibronectin In Meningitis I1mentioning

confidence: 99%

Increased intrathecal synthesis of fibronectin in bacterial and carcinomatous meningitis

Weller

Sommer

Stevens

et al. 2009

Acta Neurologica Scandinavica

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Immunoreactive fibronectin (Fn) was quantified in paired cerebrospinal fluid (CSF) and serum samples from patients with bacterial meningitis (n = 46), tick‐borne encephalitis (TBE) (n = 6), HIV infection (n = 6), Guillain‐Barré syndrome (n = 5), carcinomatous meningitis (n = 11), multiple sclerosis (n = 15), disk disease (n = 11), and controls (n = 28). A highly significant elevation of CSF Fn was found in bacterial meningitis, TBE, and carcinomatous meningitis. There were no significant differences in serum Fn between any of the groups. An Fn index to estimate the rate of intrathecal Fn synthesis reached the highest value in bacterial meningitis. Our findings suggest that CSF Fn may be an indicator of adequate host reaction and tissue repair. For diagnostic purposes, the determination of CSF Fn probably does not add much to routine CSF laboratory tests.

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Cerebrospinal Fluid Cell Counts and Chemistries in Bacterial Meningitis

Cited by 23 publications

References 0 publications

In vivo proteomics identifies the competence regulon and AliB oligopeptide transporter as pathogenic factors in pneumococcal meningitis

In vivo proteomics identifies the competence regulon and AliB oligopeptide transporter as pathogenic factors in pneumococcal meningitis

The UK joint specialist societies guideline on the diagnosis and management of acute meningitis and meningococcal sepsis in immunocompetent adults

Increased intrathecal synthesis of fibronectin in bacterial and carcinomatous meningitis

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