thromboplastin and Meningitis

Neisseria meningitidis (N. meningitidis) may cause sepsis and meningitis. N. meningitidis with a mutated lpxL1 gene has five, instead of six, acyl chains in the lipid A moiety. Compared with patients infected with the wild type (wt) meningococcus, patients infected with the lpxL1 mutant have a mild meningococcal disease with less systemic inflammation and less coagulopathy. Circulating tissue factor (TF), the main initiator of coagulation, has a central role in the development of coagulation disturbances during sepsis. To study how TF was influenced by the lpxL1 mutant, human primary monocytes and whole blood were incubated with the lpxL1 mutant or the wt meningococcus (H44/76). Monocyte and microvesicle (MV)-associated TF expression and TF-dependent thrombin generation were measured. In both purified monocytes and whole blood, our data show that the lpxL1 mutant is a weaker inducer of monocyte and MV-associated TF compared with the wt. Our data indicate that low levels of circulating TF may contribute to the reduced coagulopathy reported in patients infected with lpxL1 mutants.

Topics: Acyltransferases; Bacterial Proteins; Blood Coagulation; Cell-Derived Microparticles; Cells, Cultured; Disease Progression; Humans; Inflammation; Meningitis; Monocytes; Mutation; Neisseria meningitidis; Primary Cell Culture; Sepsis; Thromboplastin

Estimates of thromboplastic activity in 1100 samples of cerebrospinal fluid indicate that an increased activity of this clotting factor is a nonspecific indicator of abnormality in the central nervous system, much like (e.g.) an increased count of mononuclear cells and an increased protein content. However, the proportion of abnormal results obtained by these three tests can differ markedly in different neurological disorders. Increased thromboplastic activity is about 14-fold more common in bacterial meningitis than in viral meningitis; thus the thromboplastin determination can be of value in discriminating between bacterial and viral meningitis.

Topics: Cerebrospinal Fluid; Cerebrospinal Fluid Proteins; Diagnosis, Differential; Humans; Leukocyte Count; Meningitis; Monocytes; Nervous System Diseases; Thromboplastin

Testing the procoagulant activity (P.C.A.) of cerebrospinal fluid (C.S.F.) by measuring its effect on plasma-recalcification time is a useful indicator of central-nervous-system damage. C.S.F. from 22 normal children and adolescents aged 6 months to 17 years had a mean +/- S.D. P.C.A. of 14 +/- 6%. P.C.A. in 13 children with C.N.S. infection was significantly increased to 59 +/- 13%. In 8/13 of these children activity remained high (42 +/- 11%) after therapy. In patients with acute lymphatic leukemia (A.L.L.) 12 aged greater than 2 1/2 years and diagnosis had a normal activity (17 +/- 8%) and 4 patients aged less than 2 1/2 years at diagnosis had an activity of 21 +/- 8%; during C.N.S. prophylaxis with intrathecal methotrexate and/or cranial irradiation, mean activity in these 16 patients rose significantly to 41 +/- 11%. More than 2 years after treatment P.C.A. decreased towards normal in the older children but remained high in the younger group. 5 children with neurological sequelae (including 3 with A.L.L. and the post-irradiation syndrome) had the highest activities. Ether extraction showed that the active material had lipid properties. P.C.A. did not correlate with protein, lactic dehydrogenase, or cell count in C.S.F.

Topics: Adolescent; Blood Coagulation; Blood Coagulation Tests; Cerebrospinal Fluid; Child; Child, Preschool; Encephalitis; Humans; Infant; Leukemia, Lymphoid; Meningitis; Thromboplastin

Topics: Adolescent; Adult; Aged; Anticoagulants; Blood Coagulation Disorders; Blood Coagulation Factors; Child; Child, Preschool; Female; Fibrinogen; Histocytochemistry; Humans; Infant; Male; Meningitis; Meningococcal Infections; Middle Aged; Neisseria meningitidis; Prothrombin Time; Sepsis; Shock, Septic; Skin Manifestations; Thrombocytopenia; Thromboplastin

Topics: Carotid Sinus; Communicable Diseases; Ear Diseases; Humans; Meningitis; Otitis; Paranasal Sinuses; Pilonidal Sinus; Thromboplastin