Differential fatty acid analysis of cerebrospinal fluid in infants and young children with suspected meningitis

Abstract

Meningitis is relatively common in infants and young children and can cause permanent brain damage. The aim of this study was to determine whether meningitis is associated with fatty acids in cerebrospinal fluid (CSF). CSF samples from children between 3months and 6years of age admitted to the Tabriz public hospitals who met clinical criteria of meningitis were collected at enrollment. A total of 81 samples were analyzed for fatty acid profile by gas-liquid chromatography. Children with a purulent meningitis demonstrated a higher percentage of oleic acid (p<0.05, >10%) and lower percentages of omega-3 polyunsaturated fatty acids (p<0.001, <-40%) than aseptic meningitis and nonmeningitis groups did. There was an inverse relationship between CSF long-chain omega-3 fatty acids and the total number of leukocytes and differential counts of neutrophils and lymphocytes in the purulent meningitis group. Moreover, significantly lower omega-3 fatty acids (p=0.001, -37%) and higher ratio of n-6/n-3 (p=0.02, -29%) were found in patients with purulent meningitis with sepsis than in those with meningitis and no sepsis. This study provides evidence that purulent meningitis and its complication with sepsis are associated with important disturbances in CSF fatty acids, mainly deficiency in long-chain omega-3 polyunsaturated fatty acids.