Cytokine characteristic of cerebrospinal fluid from children with enteroviral meningitis compared to bacterial meningitis

Abstract

Background: Enteroviruses are the most common etiological agent for viral encephalitis, but it is uncertain whether the cytokines have the ability to differentiate enteroviral meningitis (EVM) from bacterial meningitis (BM).

Methods: A retrospective study was performed at the Children's Hospital, Zhejiang University School of Medicine from August 2016 and August 2019. CSF and/or blood specimens were collected for microbiological culture, viruses, and cytokine detection.

Results: Forty-three patients were confirmed with meningitis, 27 patients with EVM, and 16 with BM. Children with EVM were older compared with BM and Control group (P < .001). The most common presenting symptom in children with EVM was fever (96.3%) followed by headache (88.9%) and vomiting (66.7%). The occurrence of seizure was lower in both EVM and BM groups (P < .001). Serum IL-6 and serum IL-10 were lower in EVM group than BM (P = .02) and control group (IL-6, P = .01; IL-10, P < .001). IL-6, IL-10, and IFN-γ levels showed obviously increase in CSF (P < .001, respectively) in EVM group, while only IL-6 increased in CSF (P < .001) in BM group. CSF concentrations of cytokines IL-6, IL-10, TNF, and IFN-γ in children with EVM and BM were both higher than Control group (P < .001). But compared EVM group to BM group, CSF IL-2 (P = .13), IL-6 (P = .37), IL-10 (P = .98), TNF (P = .54), and IFN-γ (P = .53) showed no difference between two groups.

Conclusions: CSF cytokines elevated in both virus and bacterial meningitis, while serum elevation only occurred in bacterial infection. Still, we could not distinguish enteroviral meningitis from bacterial meningitis with the parameters of CSF cytokines IL-2, IL-6, IL-10, TNF, and IFN-γ.

Keywords: bacterial meningitis; cytokines; enteroviral meningitis.