Serum lipids in viral and bacterial meningitis

The changes in serum triglycerides (Tg), cholesterol and high density lipoprotein (HDL) cholesterol were examined in 17 patients with viral (VM) and in 7 patients with bacterial (BM) meningitis. In VM, there were low values of cholesterol (p less than 0.001) and HDL cholesterol (p less than 0.01) on admission to hospital and a rise in Tg after 1 week (p less than 0.01). In BM, caused in 4 cases by meningococci and in 3 cases by various streptococci, both cholesterol and HDL cholesterol were decreased during the acute phase (p less than 0.001 and less than 0.02, respectively). Corresponding changes were observed when the meningococcal cases were treated as a separate group (p less than 0.02 and less than 0.05, respectively). On admission cholesterol and HDL cholesterol levels in BM were lower than those in VM (p less than 0.05 in each case). In VM, the changes in serum lipids did not correlate with the changes of protein and glucose levels or leucocyte counts in cerebrospinal fluid (CSF). In BM, protein concentration in CSF correlated negatively with serum Tg (p less than 0.01) and positively with HDL cholesterol (p less than 0.05); glucose concentration in CSF correlated positively with Tg (p less than 0.01). Our results emphasize the need for further investigation of the pathophysiological role of lipids in various infections.