Compartmentalization of Lipopolysaccharide Production Correlates with Clinical Presentation in Meningococcal Disease

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Abstract
Lipopolysaccharide (LPS, endotoxin) was quantified in plasma and cerebrospinal fluid (CSF) collected simultaneously from patients with systemic meningococcal disease. High levels (median, 3800 ng/L; range, 750-14,000) were present in plasma and low levels (median, 40 ng/L; range, 9 leukocytes/L, protein levels >0.5 g/L, and a glucose ratio <0.5. Thus, quantification of LPS levels in the plasma and CSF in systemic meningococcal disease is a better predictor of pathophysiologic events than is demonstrating the presence of live bacteria as in conventional culture.

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