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Ventricular involvement in experimental Hemophilus influenzae meningitis
Abstract:
We determined the frequency of ventricular involvement during Hemophilus influenzae type b meningitis in ten bacteremic infant rhesus monkeys. Meningitis was defined as cerebrospinal fluid obtained from the lumbar subarachnoid space or cisterna magna containing bacteria and ten or more leukocytes per mm3. HIB were cultured from 22 of 22 ventricular CSF samples. In 17 of 18 comparisons of bacterial density in ventricular and cisternal CSF, the values were within one log10: similarly, 5 of 8 quantitative ventricular-lumbar comparisons were within one log10. This concordance was present at bacterial densities of 2 x 10(1) to 1 x 10(9) CFU/ml. When discordance was present, the ventricular CSF contained more bacteria. In 15 of 20 comparisons of leukocyte density in ventricular and cisternal CSF, the ventricular pleocytosis was lower (mean ventricular/cisternal ratio 0.08). We conclude that infection of the lateral cerebral ventricle is a uniform feature of HIB meningitis in infant monkeys, but the cellular inflammatory component is less.
Insights
Ventricular involvement is a consistent finding in infant rhesus monkeys with Hemophilus influenzae type b (Hib) meningitis. However, the cellular inflammatory response within the ventricles was notably reduced compared to other cerebrospinal fluid sites.
Area of Science:
- Neurology
- Infectious Diseases
- Pediatrics
Background:
- Bacterial meningitis can lead to severe neurological complications.
- Understanding the distribution of infection within the central nervous system is crucial for effective treatment.
Purpose of the Study:
- To investigate the frequency and extent of ventricular system involvement in Hemophilus influenzae type b (Hib) meningitis in a primate model.
- To compare bacterial and host inflammatory cell densities between ventricular and other cerebrospinal fluid compartments.
Main Methods:
- Ten bacteremic infant rhesus monkeys were inoculated with Hib.
- Cerebrospinal fluid (CSF) was collected from ventricular, cisternal, and lumbar spaces.
- Bacterial and leukocyte densities were quantified in all CSF samples.
Main Results:
- Hib was cultured from all 22 ventricular CSF samples analyzed.
- Bacterial densities in ventricular CSF were comparable to cisternal and lumbar CSF.
- Leukocyte densities were significantly lower in ventricular CSF compared to cisternal CSF.
Conclusions:
- Infection of the lateral cerebral ventricles is a universal characteristic of Hib meningitis in infant monkeys.
- Despite uniform bacterial presence, the cellular inflammatory response in the ventricles is diminished.