title: [Meningitis associated with tsutsugamushi disease--detection of intrathecal interferon-gamma synthesis and lymphocyte subsets in blood and CSF].
abstract: We report a case of meningitis associated with tsutsugamushi disease. The lymphocyte subpopulation study of peripheral blood revealed a reversed CD4/CD8 ratio (0.14), an increased number of activated T cells and an elevated cytotoxic T cell activity. In cerebrospinal fluid (CSF), the CD4/CD8 ratio was much higher (0.84) and activated T cells were less prevalent than in blood. These pictures of lymphocyte subsets were characteristic and different from that of viral meningitis. We also verified an elevation of interferon-gamma levels in CSF as well as in serum and intrathecal interferon-gamma synthesis while the specific antibody production in CSF compartment was not demonstrated. T cell-mediated immunity many play an important role not only systemically but also locally in the central nervous system in tsutsugamushi disease.
authors.affiliation: Department of Neurology, Asahi General Hospital.
authors.forename: M
authors.initials: M
authors.lastname: Ikeda
authors.forename: T
authors.initials: T
authors.lastname: Sato
authors.forename: H
authors.initials: H
authors.lastname: Takahashi
authors.forename: S
authors.initials: S
authors.lastname: Yoshida
authors.forename: H
authors.initials: H
authors.lastname: Tsukagoshi
mesh_terms: D016516:CD4-CD8 Ratio; D002490:Central Nervous System / Q000378:metabolism*; D006801:Humans; D007371:Interferon-gamma / Q000096:biosynthesis* / Q000134:cerebrospinal fluid; D016131:Lymphocyte Subsets; D008297:Male; D016920:Meningitis, Bacterial / Q000276:immunology* / Q000378:metabolism; D008875:Middle Aged; D012612:Scrub Typhus / Q000276:immunology* / Q000378:metabolism
chemical_list: D007371:Interferon-gamma