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Cerebrospinal fluid nitric oxide metabolites and discrimination of bacterial meningitis from other causes of encephalopathy
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  1. TREVOR DUKE,
  2. MIKE SOUTH
  1. Paediatric Intensive Care Unit
  2. Royal Children’s Hospital
  3. Parkville, Victoria 3052
  4. Australia
  5. Bernard O’Brien Institute of Microsurgery
  6. St Vincent’s Hospital
  7. Melbourne, Victoria
  8. Australia
    1. ALASTAIR STEWART
    1. Paediatric Intensive Care Unit
    2. Royal Children’s Hospital
    3. Parkville, Victoria 3052
    4. Australia
    5. Bernard O’Brien Institute of Microsurgery
    6. St Vincent’s Hospital
    7. Melbourne, Victoria
    8. Australia

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      Editor,—Nitric oxide (NO) is implicated in the pathogenesis of bacterial sepsis.1 The potential sources of NO include endothelial, smooth muscle, and inflammatory cells. Serum concentrations of nitrogen oxides are increased in patients with bacterial sepsis, compared with non-septic controls.2 3NO has also been shown to be a neurotransmitter, and has been implicated in acute and chronic brain pathology.1 We hypothesised that NO production is increased in bacterial meningitis; that this would be reflected by an increased concentration of nitrogen oxides in the cerebrospinal fluid (CSF); and that the CSF concentrations of nitrogen oxides would discriminate bacterial meningitis from other causes of fever and childhood encephalopathies. Reagent strips have recently been used for the rapid diagnosis of meningitis.4 …

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