الفهرس 
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Abstract
Meningitis can be life-threatening because of the inflammation’s proximity to the brain and spinal cord; therefore the condition is classified as a medical emergency.
Early diagnosis and starting immediate empirical therapy are the key factors to reduce the morbidity and mortality related to bacterial meningitis
Viral meningitis constitutes the most common cause of aseptic meningitis. It has good clinical outcomes in the majority of cases.
This case control study was carried out in Shebin El-Kom Fever Hospital in the period from April 2019 to February 2020.
It was conducted on a group of 90 members of children, 60 of them with definite acute meningitis diagnosed clinically and confirmed by CSF analysis and 30 are apparently normal members, selected from the inpatients and outpatient of Shebin El-Kom Fever Hospital.
They were classified retrospectively after CSF study into 3 groups:
group 1: 30 patients with BM (16 males and 14 females), their age ranged from (4 month – 14 years) years with mean age 4.22± 1.09 SD.
group 2: 30 patients with VM (12 males and 18 females) their age ranged from (1-14 years) years with mean age 6.73 ± 3.43 SD.
group 3: 30 subjects (18 males and 12 females), their age was ranging from (2-14) years with mean age 4.80 ± 1.78 SD. considered as control group as they were apparently healthy at time of study.
The aim of this work was to evaluate the level of IL-6 in serum of patients with ABM and VM.
All patients were subjected to a full history taking and thorough clinical examination. Laboratory investigations including complete blood count ,CRP, blood chemistry including random blood glucose, renal function tests (Blood urea and serum creatinine), liver function tests (AST, ALT), CSF analysis including
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physical, cytological (leukocyte count with differential), chemical (glucose and protein concentrations) and bacteriological (microscopy and culture) and assessment of serum Il-6 with ELISA.
Statistical analysis revealed that:
There was no statistically significant difference between studied groups as regarding age and sex.
There was a high statistically significant increase in the duration of hospitalization among patients with bacterial in comparison to aseptic meningitis.
All patients symptomatized with fever, there was no statistically significant difference in vomiting, convulsions, irritability, headache, refusal of feeding, photophobia, altered consciousness, neck rigidity and altered mentality among patients with BM and aseptic meningitis.
There was a high statistically significant increase in serum WBC count in patients with BM in comparison to other two groups and no significant difference in Hb concentration among patients of the studied groups.
There was no statistically significant difference in SBP between the two groups; however there were statistically significant differences in DPP, pulse, RR and temperature between them.
There was no statistically significant difference in blood glucose level and serum creatinine among the studied groups
There was a highly significant increase in turbidity of CSF in bacterial in comparison to aseptic meningitis and control group and significant increase in CSF tension in the majority of patients with bacterial and aseptic meningitis in comparison to control group.
There was a highly significant increase in CSF WBCs count CSF polymorphs % and protein and a significant decrease in CSF glucose in patients with bacterial meningitis in comparison to aseptic meningitis and control group.
There was a high statistically significant difference in serum IL 6 level among the studied groups with mean values (75 pg/ml), (35 pg/ml) and (9
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pg/ml) respectively (p value < 0.001), with higher serum IL-6 levels in bacterial than aseptic meningitis and control group.
Serum IL6 level at a cut off value more than 31 pg/ml has a sensitivity (90%), specificity of (100%) as predictor marker for meningitis with AUC=0.99, Positive predictive value was (97%) and Negative predictive value was (88%).
Serum IL6 level at a cut off value more than 48 pg/ml has a sensitivity of (99%) and specificity of (98%) to differentiate between bacterial and viral meningitis with AUC=100, Positive predictive value was (96%) and Negative predictive value was (97%).
Regarding the correlation between serum IL-6 and other studied parameters, there was negative correlation between serum IL-6 and (Lymphocytes, CSF sugar and CSF lymphocytes) (p < 0.001). Also there was positive correlation between serum IL-6 and (TLC, CRP and CSF neutrophils (P value < 0.001).