Case Report: A case of postneurosurgery Klebsiella pneumoniae meningitis with longitudinal CSF cytokine profiling and combined intrathecal therapy
- 1Department of Rehabilitation, The Third People’s Hospital of Yunnan Province
- 2Department of Neurology, First Affiliated Hospital, Kunming Medical University
Abstract
A 47-year-old woman with poorly controlled diabetes developed acute fever, headache, seizures, and progressive confusion during an admission for glycemic management. Neurological examination showed mild meningeal signs, and brain MRI demonstrated diffuse linear leptomeningeal enhancement. Lumbar puncture revealed strikingly viscous, ‘jelly-like’ cerebrospinal fluid (CSF), and culture identified Klebsiella pneumoniae . Despite systemic antimicrobial therapy, central inflammatory activity persisted. Serial CSF analyses revealed pronounced elevations of IL-1β, IL-6, and IL-8, with IL-1β closely paralleling CSF leukocyte dynamics and demonstrating relative independence from systemic inflammatory fluctuations. Clinical and laboratory improvement occurred after combined intravenous and intrathecal administration of polymyxin B, amikacin, and dexamethasone, leading to full neurological recovery. This case highlights the diagnostic significance of mucoid CSF in Klebsiella pneumoniae meningitis and underscores the therapeutic value of intrathecal antibiotics in severe central nervous system infections. Longitudinal CSF IL-1β measurements may provide a potentially useful marker of intracranial inflammatory activity and treatment response, although this requires validation in larger cohorts.
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BibTeX
@article{zhu2026case,
title = {{Case Report: A case of postneurosurgery Klebsiella pneumoniae meningitis with longitudinal CSF cytokine profiling and combined intrathecal therapy}},
author = {Lin Zhu and Qian Wu and Jing Xu and Deshan Ge and Shujuan Dai},
journal = {Frontiers in Immunology},
year = {2026},
month = oct,
doi = {10.3389/fimmu.2026.1945662},
url = {https://www.frontiersin.org/articles/10.3389/fimmu.2026.1945662/full},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Case Report: A case of postneurosurgery Klebsiella pneumoniae meningitis with longitudinal CSF cytokine profiling and combined intrathecal therapy
AU - Lin Zhu
AU - Qian Wu
AU - Jing Xu
AU - Deshan Ge
AU - Shujuan Dai
PY - 2026
DA - 2026/10/15
JO - Frontiers in Immunology
DO - 10.3389/fimmu.2026.1945662
UR - https://www.frontiersin.org/articles/10.3389/fimmu.2026.1945662/full
AB - A 47-year-old woman with poorly controlled diabetes developed acute fever, headache, seizures, and progressive confusion during an admission for glycemic management. Neurological examination showed mild meningeal signs, and brain MRI demonstrated diffuse linear leptomeningeal enhancement. Lumbar puncture revealed strikingly viscous, ‘jelly-like’ cerebrospinal fluid (CSF), and culture identified Klebsiella pneumoniae . Despite systemic antimicrobial therapy, central inflammatory activity persisted. Serial CSF analyses revealed pronounced elevations of IL-1β, IL-6, and IL-8, with IL-1β closely paralleling CSF leukocyte dynamics and demonstrating relative independence from systemic inflammatory fluctuations. Clinical and laboratory improvement occurred after combined intravenous and intrathecal administration of polymyxin B, amikacin, and dexamethasone, leading to full neurological recovery. This case highlights the diagnostic significance of mucoid CSF in Klebsiella pneumoniae meningitis and underscores the therapeutic value of intrathecal antibiotics in severe central nervous system infections. Longitudinal CSF IL-1β measurements may provide a potentially useful marker of intracranial inflammatory activity and treatment response, although this requires validation in larger cohorts.
SN - 1664-3224
ER -