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Diederik van de Beek, MD, PhD; Eelco F. M. Wijdicks, MD, PhD

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Drs de Souza and Seguro stress the importance of interactions between the cytokine network, coagulations inhibitors, and development of brain infarctions in patients with meningococcal meningitis. In their comment, they postulate a hypothesis on a causal relation between brain infarction and interleukin 6 (IL-6) in meningococcal meningitis. Although interesting, their assumptions on IL-6 and brain infarction are based on 1 single case report, and systematic evidence to support their hypothesis is lacking.¹

Bacterial meningitis is a complex disorder in which injury is caused in part by the causative organism and in part by the host's own inflammatory response, with massive activation of inflammatory cascades.² The main cascades pathways that are involved are the complement system, the inflammatory response, and the coagulation and fibrinolysis pathways, all of which are able to interact with one another.³ Cytokines coordinate . . . [Full Text of this Article]

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RELATED ARTICLE

Meningococcal Meningitis With Brainstem Infarction
Diederik van de Beek, Robin Patel, and Eelco F. M. Wijdicks
Arch Neurol. 2007;64(9):1350-1351.
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RELATED LETTER

Stroke Secondary to Meningococcal Meningitidis: A Potential Link Between Endothelial Dysfunction and Cytokines
Alexandre Leite de Souza and Antonio Carlos Seguro
Arch Neurol. 2008;65(2):283-284.
EXTRACT | FULL TEXT