الفهرس 
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Abstract
Bacterial meningitis is a serious clinical conditio, and a early and reliable diagnosis is of great importance to the outcome of the disease beacause of the necessity of immediate theraphy, the results may even be obscured if the patient had received antibiotic treatment beforehand.
The present work aimed at studying the TNF-a value in both plasma and CSF of patients with acute meiigitis for early diagnosis and differentiation between bacterial meningitis. The study was carriad out on 50 children with age ranged from 6 months to 12 years categorized into four groups, acute bacterial meningintis group and control group.
In the present study TNF-a was present in the CSF of 14 out of 15 cases with bacterial meningitis with a men value = 891.33pg/ml at the time of admission. All other 3 groups viral, partialy treated, and cotrol had non significant values of TNF- a in their CSF less than 35 pg/ml.