Study of nitric oxide in septic and aseptic meningitis in children

To study the endogenous production of nitric oxide [NO] in septic and aseptic meningitis, we measured the stable end products [nitrite and nitrate] in the cerebrospinal fluid [CSF] and serum of 14 children with septic meningitis and 16 children with aseptic meningitis. 10 children who presented with fever which required analysis of CSF to exclude the presence of meningitis represented the control group. CSF and serum levels of nitrite and nitrate were significantly increased in septic meningitis when compared with aseptic meningitis and control group. Clinical and laboratory improvement following administration of antibiotics and dexamethazone to children with septic meningitis was associated with a fall in CSF and serum [nitrite and nitrate] to normal levels in these patients. CSF [NO] remained almost consistently within the normal range in patients with aseptic meningitis. We concluded that [NO] production is enhanced in the CSF compartment of children with septic meningitis and support the hypothesis that NO contributes to the pathophysiology of septic meningitis and that this simple and rapid test is very promising as a clinically useful diagnostic tool and therapeutic monitor in the evaluation of septic meningitis in children