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Cerebrospinal fluid‐filtration reduces TNF alpha in bacterial meningitis‐CSF
Author(s) -
Pfausler B.,
Grubwieser G.,
Bösch S.,
Vollert H.,
Herald M.,
Schmutzhard E.
Publication year - 1995
Publication title -
european journal of neurology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.881
H-Index - 124
eISSN - 1468-1331
pISSN - 1351-5101
DOI - 10.1111/j.1468-1331.1995.tb00176.x
Subject(s) - cerebrospinal fluid , medicine , meningitis , tumor necrosis factor alpha , gram staining , filtration (mathematics) , cerebral spinal fluid , stain , penicillin , streptococcus pneumoniae , csf albumin , pathology , immunology , anesthesia , microbiology and biotechnology , staining , antibiotics , surgery , biology , statistics , mathematics
A 37 year old male was admitted with the diagnosis of bacterial meningitis. Pneumococci were seen in the Gram stain of the cerebrospinal fluid. The clinical condition did not suggest severely raised intracranial pressure, there were no localizing signs and symptoms. CSF was turpid, with 20.100/3/mm 3 , mainly polymorphonuclear cells. Tumor necrosis factor alpha in CSp was greatly increased with 813 pg/ml. Parallel to the application of intravenous Penicillin G a CSF filtration was carried out. Within 214 h 225 ml CSF were filtrated through a Pall‐filter, using a bidirectional pump. Cell count dropped to 720/3 cells/mm 3 , TNF‐alpha to 39 pg/ml. The clinical course was uneventful, on day 12 the patient could be discharged without sequelae. CSF filtration may be a highly effective method to reduce from the CSF pathogenetically important cytokines, such as TNF‐alpha, being responsible for intrathecal/meningeal inflammatory processes and triggered by cell‐wall components of bacteria, e.g. pneumococci.