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Case Report: A case of postneurosurgery Klebsiella pneumoniae meningitis with longitudinal CSF cytokine profiling and combined intrathecal therapy

Year: 2026

Type: article

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.

Source: Frontiers in Immunology

DOI: 10.3389/fimmu.2026.1945662

Authors: Lin Zhu, Qian Wu, Jing Xu, Deshan Ge, Shujuan Dai

Institutions: Kunming Medical University, First Affiliated Hospital of Kunming Medical University, Third People's Hospital of Yunnan Province

Language: English

Topic: Bacterial Infections and Vaccines

Subfield: Microbiology

Field: Immunology and Microbiology

Domain: Life Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $3,801