Tumor necrosis factor alpha and interleukin-1 beta levels in cerebrospinal fluid examination for the diagnosis of ventriculoperitoneal shunt-related ventriculitis.
Childs Nerv Syst
; 35(4): 629-636, 2019 04.
Article
em En
| MEDLINE
| ID: mdl-30687902
ABSTRACT
PURPOSE:
Ventriculitis is known to develop after chronic inflammation and bacterial invasion of the ventricular surface with a recurrence of shunt infections. The aim of this study is to evaluate the diagnostic value of elevation in cerebrospinal fluid (CSF) interleukin-1 beta (IL-1ß) and tumor necrosis factor alpha (TNF-α) together with CSF culture and laboratory test results in the diagnosis of ventriculoperitoneal (VP) shunt-related ventriculitis, which is known to be more problematic than conventional shunt infection.METHODS:
The study included a total of 34 patients with a VP shunt due to hydrocephalus, who presented with a headache, fever, and shunt infection at the Emergency Department and had a pre-diagnosis of ventriculitis. Nineteen patients were diagnosed with shunt-related infection or ventriculitis using the CSF obtained from the shunt pump. The IL-1ß and TNF-α levels from the CSF samples of all patients were measured using the Micro ELISA immunoassay method.RESULTS:
CSF direct microscopic observation revealed that the mean cell count, IL-1ß level, CRP level, and blood leukocyte level were higher in patients with ventriculitis compared to those diagnosed with shunt infection (p = 0.02, p = 0.009, p = 0.004, and p = 0.009, respectively). The probability of predicting positive culture outcome was 92.7% with 90.9% sensitivity and 82.6% specificity when IL-1ß values exceeded 4.0 pg/ml. TNF-α values did not show a significant, reliable pattern compared to IL-1ß.CONCLUSIONS:
IL-1ß is a reliable parameter which shall be used in the diagnosis of ventriculitis by predicting positive culture outcome with high sensitivity and specificity.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Biomarcadores
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Fator de Necrose Tumoral alfa
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Derivação Ventriculoperitoneal
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Interleucina-1beta
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Ventriculite Cerebral
Tipo de estudo:
Diagnostic_studies
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Etiology_studies
/
Prognostic_studies
Limite:
Adult
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Female
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Humans
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Male
/
Middle aged
Idioma:
En
Ano de publicação:
2019
Tipo de documento:
Article