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Serum cortisol levels in children with acute bacterial and aseptic meningitis

Sunit C Singhi1, Arun Bansal

  • 1Department of Pediatrics, Advanced Pediatrics Center, Post Graduate Institute of Medical Education and Research Center, Chandigarh, India.

Pediatric Critical Care Medicine : a Journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies
|January 6, 2006
PubMed

Insights

Serum cortisol levels in children with meningitis were studied. Very high cortisol levels were linked to neurological and hearing problems, while low levels were uncommon in bacterial meningitis.

Area of Science:

  • Pediatric Endocrinology
  • Neuroscience
  • Infectious Diseases

Background:

  • Childhood meningitis is a serious infection requiring prompt diagnosis and management.
  • Serum cortisol levels may serve as a biomarker for disease severity and patient outcomes.
  • Understanding the relationship between cortisol and meningitis sequelae is crucial for pediatric care.

Purpose of the Study:

  • To investigate serum cortisol levels in children with acute meningitis.
  • To correlate cortisol levels with disease severity and clinical characteristics.
  • To determine the association between cortisol levels and patient outcomes, including neurological and hearing status.

Main Methods:

  • A prospective observational study was conducted in a tertiary care hospital.
  • Serum cortisol levels were measured using enzyme-linked immunosorbent assay in 30 children (2 months to 12 years) with suspected bacterial meningitis.
  • Correlations were made between cortisol levels, clinical data (Glasgow Coma Scale, Pediatric Risk of Mortality), and outcomes at 2 months post-discharge.

Main Results:

  • Mean serum cortisol was higher in bacterial meningitis (467 ng/dL) than aseptic meningitis (319 ng/dL).
  • Glasgow Coma Scale score, systolic blood pressure, age, Pediatric Risk of Mortality, and cerebrospinal fluid protein predicted serum cortisol levels.
  • Patients with neurological or hearing sequelae had significantly higher median serum cortisol (450 ng/mL) compared to those without (300 ng/mL).

Conclusions:

  • Low serum cortisol is infrequent in acute bacterial meningitis of nonmeningococcal origin.
  • Elevated serum cortisol levels are associated with an increased risk of neurological and hearing sequelae in children with meningitis.
Abstract

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