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The levels of tumor necrosis factor-α (TNF-α) and interleukin (IL)-1β in the cerebrospinal fluid (CSF) of 66 patients with coccidioidal meningitis during therapy with fluconazole were measured by ELISA. The median concentration of TNF-α was 15.2 pg/ml, for 322 samples; for IL-1β, it was 4.7 pg/ml, for 316 samples. There were no significant changes in the level of either cytokine over 24 months of follow-up nor was there an association between the initial CSF concentrations of TNF-α and IL-1β and subsequent fluconazole treatment failure. Over time, concentrations of IL-1β were significantly associated with both clinical symptoms and white blood cell counts in CSF. These results indicate that CSF levels of TNF-α and IL-1β are relatively low compared with those associated with acute bacterial meningitis. [ABSTRACT FROM PUBLISHER]