Cytokines play a role in meningeal
inflammation and leukocyte recruitment. Research has demonstrated that levels of different
cytokines are elevated in aseptic and
viral meningitis. Unfortunately, previous data were confounded by the inclusion of multiple viral agents as a study group. The aims of the study were to determine the cerebrospinal fluid concentrations of various
cytokines in an outbreak of a single viral agent and to correlate between
cytokine levels and leukocytes. Cerebrospinal fluid samples, collected during an outbreak of echovirus type 4
meningitis in infants and children in Israel, were tested for routine characteristics. In addition,
cytokine levels were measured in 71
meningitis patients and compared with those of 11 nonmeningitis patients. Concentrations of
interleukin-6 (2417 +/- 2713 vs 28 +/- 20 pg/mL; P < 0.01) and
interferon gamma (36 +/- 38 vs 4.8 +/- 0.9 pg/mL; P < 0.01) were significantly higher in patients with
meningitis than in the control group, whereas soluble
intercellular adhesion molecule-1 (1.12 +/- 2.6 vs 0.06 +/- 0.1 ng/mL) levels did not differ significantly. In addition, only
interleukin-6 levels correlated with leukocyte counts in
viral meningitis patients.
Interleukin-6 was the most sensitive and specific characteristic in predicting
meningitis in this homogeneous group of patients. Furthermore, only
interleukin-6 correlated with leukocyte counts in the cerebrospinal fluid.