muramidase and Meningitis--Viral

The authors have modified the technique of the lysozyme test by adding polimixin M sulfate into the gel bacterial medium. Rapid diagnosis with the use of this test is based on different time of the appearance of the lysis areas: in bacterial meningitides the CSF lysozyme activity is detectable within 15-120 min, whereas in viral meningitides it manifests 40-50 min later or does not manifest at all. The results were found to depend on the time of the CSF collection: the earlier the CSF samples were obtained, the higher was the share of positive results.

Topics: Clinical Enzyme Tests; Diagnosis, Differential; Gels; Humans; Meningitis, Bacterial; Meningitis, Viral; Muramidase; Polymyxins; Time Factors

Three variants of the immunoenzymometric assay of human lysozyme with HRP-labeled antibodies were compared. The highest sensitivity (with a detection limit of 0.2 micrograms lysozyme/L) was achieved by a one-step assay lasting 2 h. Between-batch precision for the techniques was 6-11%. Lysozyme reference values were determined in serum, cerebrospinal fluid and urine. In serum they are age-dependent and in urine sex-dependent when related to creatinine excretion. Serum lysozyme is increased in only 57% of the patients with active rheumatoid arthritis and is also unreliable for indicating remission. In Crohn's disease the serum lysozyme reflects activity better, but it does not exceed the diagnostic value of alpha-1-acidic glycoprotein (orosomucoid). The lysozyme quantification in cerebrospinal fluid is useful in distinguishing between viral or bacterial meningitis.

Topics: Acute Disease; Adolescent; Adult; Aged; Aging; Arthritis, Rheumatoid; Body Fluids; Clinical Enzyme Tests; Crohn Disease; Diagnosis, Differential; Enzyme Stability; Evaluation Studies as Topic; Humans; Immunoenzyme Techniques; Infant, Newborn; Meningitis; Meningitis, Viral; Middle Aged; Muramidase; Nervous System Diseases; Reference Values

A turbidimetric technique has been adapted to yield maximum sensitivity for the measurement of lysozyme in cerebrospinal fluid. One hundred and ninety-eight patients were studied over a total period of 9 months using this technique. In addition to the considerably elevated levels known to occur in cases of bacterial and fungal meningitis, increased activity was also demonstrated in cases of subarachnoid haemorrhage and in certain inflammatory conditions. Normal or marginally increased levels were seen in cases of viral meningitis and encephalitis.

Topics: Bacterial Infections; Encephalitis; Humans; Meningitis; Meningitis, Viral; Muramidase; Nephelometry and Turbidimetry; Nervous System Diseases

The significance of the measurement of lactate, lysozyme and PHI in CSF for differential diagnosis of meningitis was examined in 58 cases of viral, 36 of bacterial and 5 of tuberculous etiology. In the early phase of the illness CSF lactate was found to be the most sensitive parameter for distinction of viral from bacterial or tuberculous meningitis respectively. Except for one case CSF lactate exceeded 3.8 mmol/l in all cases of bacterial etiology, whereas this value was never reached in any case of viral meningitis. While lactate concentration was maximal on the day of admission and declined continuously thereafter, PHI activity reached its maximum on the third day after beginning of the therapy. At this time all patients with a bacterial or tuberculous meningitis had PHI activities about 50 U/l. This value wasn't exceeded in any case of viral meningitis. In a few cases some days after onset of therapy a distinction of bacterial meningitis from viral forms was still possible by PHI determination but not by lactate measurement. Determination of lysozyme also could be helpful in the later phase of the disease.

Topics: Bacterial Infections; Cryptococcosis; Diagnosis, Differential; Glucose-6-Phosphate Isomerase; Humans; Lactates; Lactic Acid; Meningitis; Meningitis, Viral; Muramidase; Mycoplasma Infections; Tuberculosis, Meningeal

We describe a simple, rapid, sensitive, and highly reproducible assay for lysozyme, with use of concentrated cell suspensions of Micrococcus lysodeikticus in Tris-buffered glycerol/water (40/60 by vol), pH 7.5. Stored at -20 degrees C, the cells' susceptibility to lysozyme remains unaltered over long periods. Almost identical concentration curves were obtained with different aliquots of the same preparation during eight months. Lysozyme activity was reflected in the decrease in absorbance of the reaction mixture after incubation for 15 min at 37 degrees C. Concentrations of egg-white lysozyme as low as 0.02 mg/L can be accurately assayed.

Topics: Biological Assay; Humans; Kinetics; Leukemia; Meningitis; Meningitis, Viral; Micrococcus; Muramidase

Topics: Clinical Enzyme Tests; Diagnosis, Differential; Humans; Meningitis; Meningitis, Aseptic; Meningitis, Viral; Muramidase

The concentration of lysozyme (LZM) in cerebrospinal fluid was determined in 25 patients with bacterial meningitis, in 18 patients with viral meningitis and in 25 control patients who had other fibrile illnesses. The concentration of LZM was less than 1.5 microgram/ml in all control patients, and slightly to markedly raised in 10 patients with viral meningitis and in 11 out of 13 patients with untreated bacterial meningitis. The concentration of LZM was significantly different in the viral and bacterial meningitis patients (p less than 0.001). Most raised concentrations of cerebrospinal fluid LZM persisted for at least one week after the start of antibiotic treatment. The concentrations of LZM correlated well with concentrations of lactic dehydrogenase. These results show that the determination of cerebrospinal fluid LZM is a useful tool in the differential diagnosis of meningitis, particularly when the prehospital treatment with antibiotics may be responsible for a diagnostically misleading negative bacterial culture of the cerebrospinal fluid and altered cerebrospinal fluid cytology.

Topics: Diagnosis, Differential; Echovirus Infections; Humans; L-Lactate Dehydrogenase; Meningitis, Meningococcal; Meningitis, Pneumococcal; Meningitis, Viral; Mumps; Muramidase

Lysozyme is absent from normal cerebrospinal fluid (C.S.F.) and in C.S.F. from children with viral meningitis. Appreciable amounts of lysozyme were noted in C.S.F. from children with bacterial meningitis (0.23 +/- 0.14 mg/100 ml) and cerebral convulsions (0-0.82 mg/100 ml). The C.S.F.-lysozyme content is a sensitive indicator for bacterial meningitis and important in the differential diagnosis between viral and bacterial meningitis. The beta2-microglobulin content of C.S.F. in healthy children was 0.11 +/- 0.05 mg/100 ml; in children with viral meningitis 0.20 +/- 0.06 mg/100 ml and in children with bacterial meningitis 0.44 +/- 0.17 mg/100 ml. Children with cerebral convulsions had also a rise in C.S.F. beta2-microglobulin.

Topics: Adolescent; beta 2-Microglobulin; Beta-Globulins; Cerebrospinal Fluid Proteins; Child; Child, Preschool; Humans; Infant; Meningitis; Meningitis, Viral; Muramidase; Seizures; Seizures, Febrile

The bacteriolytic activity of 153 samples of cerebrospinal fluid (CSF) from patients with various diseases was measured by determining the ability of the CSF to cause lysis of a suspension of killed cells of Micrococcus lysodeikticus. Normal CSF did not show significant bacteriolytic activity. A high activity was found in patients with bacterial meningitis (mainly meningococcal), only to some extent correlated with the protein and cell content of the CSF. Slight elevation of protein and cell content of CSF in patients with diseases other than bacterial meningitis was not accompanied by significant bacteriolytic activity. The CSF from a patient with lymfosarcoma, with as much as 2300 cells/mm3, thus was negative. Also the CSF from patients with serous (viral) meningitis was usually negative. Measurement of bacteriolytic activity in CSF may be of diagnostic importance in cases presenting slight elevation of cell number and protein. Further studies of the significance of the bacteriolytic response in meningitis caused by different microorganisms are warranted.

Topics: Adolescent; Aged; Bacteriolysis; Cerebrospinal Fluid; Child; Child, Preschool; Humans; Infant; Meningitis; Meningitis, Viral; Micrococcus; Middle Aged; Muramidase

Cerebrospinal fluid (CSF) and serum lysozyme concentrations were determined in infants and children with and without acute infectious disease of the central nervous system. Serum lysozyme values from patients with bacterial and viral meningitis were found within the normal range. Lysozyme activity was absent or very low (below 0.5 microgram/ml) in normal CSF. High levels (4-12 microgram/ml) in patients with viral meningitis. A decrease of the lysozyme activity coincided with the clinical improvement of the bacterial meningitis. The lysozyme activity in CSF should be of significant value in detecting an inflammatory disease of the central nervous system.

Topics: Bacterial Infections; Child; Child, Preschool; Humans; Infant; Meningitis; Meningitis, Viral; Muramidase

Topics: Clinical Enzyme Tests; Diagnosis, Differential; Humans; Meningitis; Meningitis, Meningococcal; Meningitis, Viral; Methods; Muramidase