Dexamethasone decreases cerebrospinal fluid soluble tumor necrosis factor receptor 1 levels in bacterial meningitis

Unusual exanthema combined with cerebral vasculitis in pneumococcal meningitis: a case report

“…Although previously controversial, as steroids reduce antibiotic penetration into the CSF, meta-analysis of trial data now support treatment with a short course of adjunctive therapy with the corticosteroid dexamethasone to improve outcome and partially prevent neurological sequelae from bacterial meningitis in adults and children [14]; this is however only achieved when given early in the disease course and when started with or before parenteral antibiotics [14]. It has been recently suggested that dexamethasone inhibits increase of CSF soluble tumor necrosis factor 1 levels after antibiotic therapy in bacterial meningitis, an important indicator of neurological sequelae in bacterial meningitis [15]. …”