       Document 0094
 DOCN  M9590094
 TI    A persistent biochemical marker for partially treated
       meningitis/ventriculitis.
 DT    9509
 AU    Katnik R; Michigan State University, Department of Pediatrics/Human;
       Development, Kalamazoo 49008, USA.
 SO    J Child Neurol. 1995 Mar;10(2):93-9. Unique Identifier : AIDSLINE
       MED/95301873
 AB    Regulation of circulating iron is important in bacterial, yeast, and
       fungal infections. In the present study, cerebrospinal fluid levels of
       ferritin, an iron-binding protein, were determined in controls and in
       patients with central nervous system pyogenic and viral infections.
       Among 441 controls, cerebrospinal fluid ferritin level was higher than
       18 ng/mL in two relapsed patients with central nervous system leukemia,
       12 with bacteremia or pneumonia, and one with hemorrhagic herpes simplex
       encephalitis. Cerebrospinal fluid ferritin levels were more than 18
       ng/mL in 13 of 63 patients diagnosed with nonhemorrhagic aseptic
       meningitis/ventriculitis, when defined solely by negative cerebrospinal
       fluid culture. Conversely, cerebrospinal fluid ferritin exceeded 18
       ng/mL in culture-proven meningitis (46 of 47 cases) and ventriculitis
       (five of five cases). Cases of indolent cryptococcus and tuberculous
       meningitis showed modest increases despite traditional cerebrospinal
       fluid markers, at times, being normal. Cerebrospinal fluid ferritin
       levels did not correlate with cerebrospinal fluid neutrophil count,
       cerebrospinal fluid protein concentration, serum ferritin level, or
       patient age. In 16 of 19 cases monitored sequentially during ongoing
       antibiotic treatment, levels remained over 18 ng/mL (average, 15.0 days;
       range, 1 to 54 days). This observation suggests that obtaining
       cerebrospinal fluid ferritin levels is helpful whenever traditional
       laboratory benchmarks normalize, as during acute or chronic antibiotic
       therapy, or create confusion with positive cultures stemming from sample
       contamination.
 DE    Adolescence  Adult  Aged  Aged, 80 and over  AIDS-Related Opportunistic
       Infections/CEREBROSPINAL FLUID/  DIAGNOSIS  Biological Markers  Blood
       Glucose/METABOLISM  *Cerebral Ventricles/METABOLISM  Child  Child,
       Preschool  Female  Ferritin/*CEREBROSPINAL FLUID  Human  Infant
       Leukocyte Count  Male  Meningitis, Aseptic/CEREBROSPINAL
       FLUID/*DIAGNOSIS/DRUG THERAPY  Meningitis, Bacterial/CEREBROSPINAL
       FLUID/*DIAGNOSIS/DRUG THERAPY  Meningitis, Viral/CEREBROSPINAL
       FLUID/*DIAGNOSIS/DRUG THERAPY  Middle Age  Neutrophils  Predictive Value
       of Tests  Recurrence  Reference Values  JOURNAL ARTICLE

       SOURCE: National Library of Medicine.  NOTICE: This material may be
       protected by Copyright Law (Title 17, U.S.Code).

