Epidural abscess laboratory findings
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Epidural abscess Microchapters |
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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] T
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:
- Staphylococcus aureus
- 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. In the case of material from the abscess, the chance of finding the responsible organism in the abscess is 90%, in the blood 62%, and in the cerebrospinal fluid about 19%.[3]
References
- ↑ 1.0 1.1 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.
- ↑ 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.