title: Cortisol kinetics in cerebrospinal fluid during bacterial meningitis.
abstract: Bacterial meningitis (BM) remains an infectious disease with a significant morbidity and mortality. The aim of this study was to describe the kinetics of cerebrospinal fluid (CSF) cortisol levels during BM and to assess its relationship to disease severity and etiology. A total of 55 patients with BM were enrolled in the study. Elevated CSF cortisol upon admission and its rapid decrease after starting therapy were associated with increased BM severity as assessed by the Acute Physiology and Chronic Health Evaluation II score, the Sequential Organ Failure Assessment score, Glasgow Coma Scale score and the Glasgow Outcome Scale score. The comparison of CSF cortisol according to BM etiology revealed a trend toward higher concentrations in meningitis caused by Streptococcus pneumoniae compared to Neisseria meningitidis. Our results demonstrate that the initially elevated CSF cortisol concentrations decrease rapidly after administration of BM therapy (i.e. antibiotics and dexamethasone). Moreover, this rapid reduction of CSF cortisol was found in patients with high severity scores.
authors.affiliation: Department 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.
authors.forename: O
authors.initials: O
authors.lastname: Beran
authors.forename: O
authors.initials: O
authors.lastname: Dzupova
authors.forename: M
authors.initials: M
authors.lastname: Holub
mesh_terms: D018806:APACHE; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D003907:Dexamethasone / Q000627:therapeutic use; D005260:Female; D015600:Glasgow Coma Scale; D023261:Glasgow Outcome Scale; D006801:Humans; D006854:Hydrocortisone / Q000134:cerebrospinal fluid*; D007700:Kinetics; D008297:Male; D016920:Meningitis, Bacterial / Q000134:cerebrospinal fluid* / Q000188:drug therapy / Q000382:microbiology*; D008875:Middle Aged
chemical_list: D000900:Anti-Bacterial Agents; D000893:Anti-Inflammatory Agents; D003907:Dexamethasone; D006854:Hydrocortisone