Brain abscess laboratory tests

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

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Overview

Imaging studies are most useful in making a diagnosis of brain abscesses. Most laboratory findings are not diagnostic for brain abscesses.

Laboratory Findings

Primary laboratory findings consistent with the diagnosis of brain abscesses include cerebral spinal fluid (CSF), erythrocyte sedimentation rate (ESR, and electroencephalogram (EEG).

• In one particular study, 41 out out 140 patients tested deteriorated within 48 hours of lumbar puncture, and out of those 41 patients, 25 died.
• Findings involving CSF are nonspecific.
• The ESR is usually elevated in the 40 – 50 range, but again, can also be normal.
• The EEG is abnormal in most patients as the brain abscess lateralizes to the side of the lesion.
• Patients usually have a moderate leukocytosis (< 20k), yet up to 40% can have a normal WBC count.

• Obtaining tissue is demonstrates the pathogen in close to 100% of cases.