Epidural abscess laboratory findings: Difference between revisions
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__NOTOC__ | __NOTOC__ | ||
{{Epidural abscess}} | {{Epidural abscess}} | ||
{{CMG}} | {{CMG}} {{AE}} {{JS}}; {{AG}} | ||
==Overview== | ==Overview== | ||
Laboratory findings consistent with the diagnosis of epidural abscess include elevated inflammatory markers, abnormal [[platelet count]], and presence of ''[[Staphylococcus aureus]]''. Laboratory results, while helpful, are not diagnostic of epidural abscess. Laboratory findings should supplement clinical and imaging findings to aid in the diagnosis.<ref name="Darouiche2006">{{cite journal|last1=Darouiche|first1=Rabih O.|title=Spinal Epidural Abscess|journal=New England Journal of Medicine|volume=355|issue=19|year=2006|pages=2012–2020|issn=0028-4793|doi=10.1056/NEJMra055111}}</ref> | |||
==Laboratory Findings== | ==Laboratory Findings== | ||
Laboratory findings consistent with the diagnosis of epidural abscess include elevated inflammatory markers, abnormal [[platelet count]], and presence of foreign organisms within the abscess. | |||
Once an [[abscess]] has been identified | ===Erythrocyte Sedimentation Rate=== | ||
An elevated [[erythrocyte sedimentation rate]] is observed in about 2/3 of patients.<ref name="Darouiche2006">{{cite journal|last1=Darouiche|first1=Rabih O.|title=Spinal Epidural Abscess|journal=New England Journal of Medicine|volume=355|issue=19|year=2006|pages=2012–2020|issn=0028-4793|doi=10.1056/NEJMra055111}}</ref> | |||
===C-Reactive Protein=== | |||
An elevated [[C-reactive protein]] level is present. | |||
===Leukocytosis=== | |||
A marked [[leukocytosis]] is present in approximately 2/3 of patients. | |||
===Platelet count=== | |||
[[Thrombocytosis]] may be present, particularly in children with epidural abscess.<ref name="Grewal2006">{{cite journal|last1=Grewal|first1=S.|title=Epidural abscesses|journal=British Journal of Anaesthesia|volume=96|issue=3|year=2006|pages=292–302|issn=0007-0912|doi=10.1093/bja/ael006}}</ref> [[Thrombocytopenia]] may be present, particularly in adults.<ref name="Grewal2006">{{cite journal|last1=Grewal|first1=S.|title=Epidural abscesses|journal=British Journal of Anaesthesia|volume=96|issue=3|year=2006|pages=292–302|issn=0007-0912|doi=10.1093/bja/ael006}}</ref> | |||
===Foreign organisms=== | |||
[[Bacteremia]] is detected in about 60% of patients. On laboratory analysis, the following microorganisms are commonly observed:<ref name="pmid19793660">{{cite journal |vauthors=Mat Nayan SA, Mohd Haspani MS, Abd Latiff AZ, Abdullah JM, Abdullah S |title=Two surgical methods used in 90 patients with intracranial subdural empyema |journal=J Clin Neurosci |volume=16 |issue=12 |pages=1567–71 |year=2009 |pmid=19793660 |doi=10.1016/j.jocn.2009.01.036 |url=}}</ref><ref name="Darouiche2006">{{cite journal|last1=Darouiche|first1=Rabih O.|title=Spinal Epidural Abscess|journal=New England Journal of Medicine|volume=355|issue=19|year=2006|pages=2012–2020|issn=0028-4793|doi=10.1056/NEJMra055111}}</ref><ref name="pmid11112668">{{cite journal |vauthors=Auletta JJ, John CC |title=Spinal epidural abscesses in children: a 15-year experience and review of the literature |journal=Clin. Infect. Dis. |volume=32 |issue=1 |pages=9–16 |year=2001 |pmid=11112668 |doi=10.1086/317527 |url=}}</ref> | |||
*''[[Staphylococcus aureus]]'' | |||
*''[[Escherichia coli]]'' | |||
*''[[Pseudomonas aeruginosa]]'' | |||
*[[Peptostreptococcus|Peptostreptococci]] and other [[Gram-positive bacteria]] | |||
*[[Anaerobic organism|Anaerobic]] [[Gram-negative bacteria]] | |||
**[[Bacteroides]] | |||
**[[Prevotella]] | |||
**[[Porphyromonas]] | |||
Once an [[abscess]] has been identified on the imaging studies, it is important to identify the responsible organism by studying different types of isolated materials, such as [[blood]], material from the [[abscess]] and [[cerebrospinal fluid]]. The chance of finding the responsible organism in the abscess is 90%, in the [[blood]] 62%, and in the [[cerebrospinal fluid]] about 19%.<ref name="pmid1359381">{{cite journal| author=Darouiche RO, Hamill RJ, Greenberg SB, Weathers SW, Musher DM| title=Bacterial spinal epidural abscess. Review of 43 cases and literature survey. | journal=Medicine (Baltimore) | year= 1992 | volume= 71 | issue= 6 | pages= 369-85 | pmid=1359381 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=1359381 }} </ref> | |||
==References== | ==References== | ||
{{Reflist|2}} | {{Reflist|2}} | ||
[[Category:Disease]] | [[Category:Disease]] | ||
[[Category:Neurology]] | [[Category:Neurology]] | ||
Latest revision as of 21:36, 29 July 2020
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Epidural abscess Microchapters |
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Epidural abscess laboratory findings On the Web |
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American Roentgen Ray Society Images of Epidural abscess laboratory findings |
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Risk calculators and risk factors for Epidural abscess laboratory findings |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: João André Alves Silva, M.D. [2]; Anthony Gallo, B.S. [3]
Overview
Laboratory findings consistent with the diagnosis of epidural abscess include elevated inflammatory markers, abnormal platelet count, and presence of Staphylococcus aureus. Laboratory results, while helpful, are not diagnostic of epidural abscess. Laboratory findings should supplement clinical and imaging findings to aid in the diagnosis.[1]
Laboratory Findings
Laboratory findings consistent with the diagnosis of epidural abscess include elevated inflammatory markers, abnormal platelet count, and presence of foreign organisms within the abscess.
Erythrocyte Sedimentation Rate
An elevated erythrocyte sedimentation rate is observed in about 2/3 of patients.[1]
C-Reactive Protein
An elevated C-reactive protein level is present.
Leukocytosis
A marked leukocytosis is present in approximately 2/3 of patients.
Platelet count
Thrombocytosis may be present, particularly in children with epidural abscess.[2] Thrombocytopenia may be present, particularly in adults.[2]
Foreign organisms
Bacteremia is detected in about 60% of patients. On laboratory analysis, the following microorganisms are commonly observed:[3][1][4]
- Staphylococcus aureus
- Escherichia coli
- Pseudomonas aeruginosa
- Peptostreptococci and other Gram-positive bacteria
- Anaerobic Gram-negative bacteria
Once an abscess has been identified on the imaging studies, it is important to identify the responsible organism by studying different types of isolated materials, such as blood, material from the abscess and cerebrospinal fluid. The chance of finding the responsible organism in the abscess is 90%, in the blood 62%, and in the cerebrospinal fluid about 19%.[5]
References
- ↑ 1.0 1.1 1.2 Darouiche, Rabih O. (2006). "Spinal Epidural Abscess". New England Journal of Medicine. 355 (19): 2012–2020. doi:10.1056/NEJMra055111. ISSN 0028-4793.
- ↑ 2.0 2.1 Grewal, S. (2006). "Epidural abscesses". British Journal of Anaesthesia. 96 (3): 292–302. doi:10.1093/bja/ael006. ISSN 0007-0912.
- ↑ Mat Nayan SA, Mohd Haspani MS, Abd Latiff AZ, Abdullah JM, Abdullah S (2009). "Two surgical methods used in 90 patients with intracranial subdural empyema". J Clin Neurosci. 16 (12): 1567–71. doi:10.1016/j.jocn.2009.01.036. PMID 19793660.
- ↑ Auletta JJ, John CC (2001). "Spinal epidural abscesses in children: a 15-year experience and review of the literature". Clin. Infect. Dis. 32 (1): 9–16. doi:10.1086/317527. PMID 11112668.
- ↑ Darouiche RO, Hamill RJ, Greenberg SB, Weathers SW, Musher DM (1992). "Bacterial spinal epidural abscess. Review of 43 cases and literature survey". Medicine (Baltimore). 71 (6): 369–85. PMID 1359381.