Association of tumour necrosis factor alpha & malnutrition with outcome in children with acute bacterial meningitis.
OBJECTIVE
Tumour necrosis factor alpha (TNF alpha) is implicated in the pathogenesis of acute bacterial meningitis (ABM). However, we do not know if the nutritional status influences the concentration of TNF alpha in the CSF in children with ABM. The present study evaluates the association between malnutrition and TNF alpha detectability in CSF and the outcome from ABM in children.


METHODS
A total of 120 children aged 1-5 yr diagnosed as ABM, based on the standard criteria of CSF changes were recruited for the study. A CSF sample was collected at the time of admission. TNF alpha was measured by ELISA and CSF culture was done by standard technique. Nutritional status was assessed by anthropometry. Outcome was measured by clinical examination.


RESULTS
Of the 120 children, 20 died, 36 developed complications and 64 children recovered without sequelae. TNF alpha was detectable in 94 (78.3%) CSF samples, with a range of 32 to 1714 pg/ml. TNF alpha detectability was not associated with either nutritional status or with death and sequelae. However, death and sequelae were significantly (P = 0.01) associated with malnutrition.


CONCLUSIONS
CSF TNF alpha was not associated with nutritional status. However, malnutrition was associated with adverse outcome due to ABM in children.
Clinical Division, Paediatrics, National Institute of Nutrition (ICMR), Hyderabad, India.
R
R
Hemalatha
P
P
Bhaskaram
N
N
Balakrishna
I
I
Saraswathi
D000208:Acute Disease; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D016920:Meningitis, Bacterial / Q000150:complications* / Q000401:mortality*; D009748:Nutrition Disorders / Q000150:complications*; D014409:Tumor Necrosis Factor-alpha / Q000134:cerebrospinal fluid*
D014409:Tumor Necrosis Factor-alpha