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Published on: July 1, 2018
Cortisol kinetics in cerebrospinal fluid during bacterial meningitis
1Department of Infectious and Tropical Diseases, First Faculty of Medicine, Charles University in Prague and University Hospital Bulovka, Budinova 2, Prague 8 CZ-180 81, Czech Republic.
Summary
Elevated cerebrospinal fluid (CSF) cortisol in bacterial meningitis (BM) indicates severity. Rapidly decreasing CSF cortisol after treatment correlates with better outcomes in severe BM cases.
Area of Science:
- Neurology
- Infectious Diseases
- Endocrinology
Background:
- Bacterial meningitis (BM) is a severe infection with high morbidity and mortality.
- Cerebrospinal fluid (CSF) cortisol dynamics in BM are not well understood.
- Understanding CSF cortisol may offer insights into disease severity and treatment response.
Purpose of the Study:
- To investigate the kinetics of CSF cortisol levels in patients with BM.
- To correlate CSF cortisol levels with BM severity and etiological factors.
- To assess the impact of therapy on CSF cortisol concentrations.
Main Methods:
- Prospective study of 55 patients diagnosed with BM.
- Measurement of CSF cortisol levels at admission and during therapy.
- Assessment of disease severity using established scores (APACHE II, SOFA, GCS, GOSE).
Main Results:
- Elevated CSF cortisol at admission was associated with increased BM severity.
- A rapid decrease in CSF cortisol after initiating antibiotic and dexamethasone therapy was observed.
- Higher CSF cortisol concentrations showed a trend in Streptococcus pneumoniae meningitis compared to Neisseria meningitidis.
Conclusions:
- Initially elevated CSF cortisol levels in BM decrease rapidly with standard therapy.
- The rate of CSF cortisol reduction is linked to disease severity.
- CSF cortisol kinetics may serve as a biomarker for BM severity and treatment response.
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