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   J Child Neurol 1995 Mar;10(2):93-99
   
A persistent biochemical marker for partially treated meningitis/ventriculitis.

    Katnik R
    
   Michigan State University, Department of Pediatrics/Human Development,
   Kalamazoo 49008, USA.
   
   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.
   
   PMID: 7782615, UI: 95301873
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