• Liliya Pekova Dept. of Infectious Diseases, Medical Faculty, Trakia University
  • Krasimira Halacheva Dept. of Molecular biology, Immunology and Medical genetics, Medical Faculty, Trakia University, Stara Zagora, Bulgaria
  • Ivaylo Dochev Dept.of Ophthalmology, University hospital, Stara Zagora, Bulgaria


neuroinfections, IL-6, IFN-γ, prognosis


Neuroinfections are acute inflammatory diseases of the central and peripheral nervous system that can lead to serious consequences, and even death. Recently, viruses have played a leading role in the emergence of neuroinfections. Rapid identification of the etiological agents is an important prerequisite for proper therapy and a good outcome of the disease. The aim of this study is to determine the role of the cytokines IL-6 and IFN-γ in the cerebrospinal fluid and serum of patients with viral and bacterial neuroinfections in relation to their diagnosis and prognosis.

Materials and methods: From 2012-2018, 91 patients were included, aged from 2 months to 82 years. They were divided into 3 groups: 57 with viral neuroinfections , 24 - with bacterial and 10 - control group with cerebral edema. Clinical, epidemiological, laboratory, microbiological, serological and molecular tests were performed in all patients, and in some of them imaging techniques (CT and MRI) had been performed. Cytokines IL-6 and IFN-γ in serum and cerebrospinal fluid were determined by immunological tests.

Conclusion: Viral neuroinfections are more common than bacterial ones, they had a milder clinical course and a more favorable outcome. Cytokine levels in the cerebrospinal fluid are a better indicator of inflammatory process in terms of severity than those in the serum. IL-6 levels in the cerebrospinal fluid of viral neuroinfections were higher than IFN-γ. A proportional relationship was established between leukocytes and IL-6 in the cerebrospinal fluid of patients with aseptic meningitis.


Zhang JM, An J “Cytokines, inflammation, and pain”. International Anesthesiology Clinics. 2007;45 (2): 27–37

Titmarsh CJ, Moscovis SM, Hall S et al.Comparison of cytokine gene polymorphisms among Greek patients with invasive meningococcal disease or viral meningitis. J Med Microbiol. 2013;62:694–700

Prasad, R., Kapoor, R., Srivastava, R., Mishra, O. P., and Singh, T. B. Cerebrospinal fluid TNF-alpha, IL-6, and IL-8 in children with bacterial meningitis, Pediatr. Neurol., 2014;50: 60–65

Qing Ye, Wen-Xia Shao, Shi-Qiang Shang, Hong-Qiang Shen, Xue-Jun Chen, Yong-Min Tang, Yong-Lin Yu, Jian-Hua Mao. Clinical Value of Assessing Cytokine Levels for the Differential Diagnosis of Bacterial Meningitis in a Pediatric Population.Medicine (Baltimore) 2016 Mar; 95(13): e3222

Pinto Junior, VL, Rebelo, MC, Gomes, RN, Assis, EF, Castro- Faria-Neto, HC, Boia, MN.IL-6 and IL-8 in cerebrospinal fluid from patients with aseptic meningitis and bacterial meningitis: their potential role as a marker for differential diagnosis, Braz. J. Infect. Dis., 2011;15: 156–158

Atreya R, Mudter J, Finotto S, et al. Blockade of interleukin 6 transsignaling suppresses T-cell resistance against apoptosis in chronic intestinal inflammation: evidence in Crohn disease and experimental colitis in vivo (vol 6, pg 583, 2000). Nature Med 2010; 16:1341–11341.

Wang Y, Guo G, Wang H, et al. Comparative study of bacteriological culture and real-time fluorescence quantitative PCR (RT-PCR) and multiplex PCR-based reverse line blot (mPCR/RLB) hybridization assay in the diagnosis of bacterial neonatal meningitis. BMC Pediatr 2014; 14

Logan, S. A., and MacMahon, E. Viral meningitis, BMJ. 2008; 336:36–40

Ichiyama T, Nishikawa M, Yoshitomi T, Hayashi T, Furukawa STumor necrosis factor-alpha, interleukin-1 beta, and interleukin-6 in cerebrospinal fluid from children with prolonged febrile seizures. Comparison with acute encephalitis/encephalopathy. Neurology. 1998;50(2):407-11.

Takahashi T, Kamei S, Miki K, Ogawa K, Mizutani T. The analysis of cytokines in cerebrospinal fluid (CSF) in two cases of non-herpetic acute limbic encephalitis (NHALE) Rinsho Shinkeigaku.2003;43(4):162-9

Takahashi W, Nakada TA, Abe R, et al. Usefulness of interleukin 6 levels in the cerebrospinal fluid for the diagnosis of bacterial meningitis. J Crit Care 2014; 29:e691–696.693

Mukai AO, Krebs VL, Bertoli CJ, Okay TS. TNF-alpha and IL-6 in the diagnosis of bacterial and aseptic meningitis in children. Pediatr Neurol. 2006 Jan;34(1):25-9

Ohga S, Aoki T, Okada K, et alCerebrospinal fluid concentrations of interleukin-1 beta, tumour necrosis factor-alpha, and interferon gamma in bacterial meningitis.Archives of Disease in Childhood 1994;70:123-125.

Babu GN, Kumar A, Kalita J, et al. Proinflammatory cytokine levels in the serum and cerebrospinal fluid of tuberculous meningitis patients. Neuroscience Letters ;2008;436(1):48-51




How to Cite

Pekova, L., Halacheva, K., & Dochev, I. (2021). COMPARATIVE ANALYSIS OF CLINICAL AND LABORATORY PARAMETERS BETWEEN VIRAL AND BACTERIAL NEUROINFECTIONS. PROBLEMS of Infectious and Parasitic Diseases, 49(1), 26–31. Retrieved from