Brain abscess laboratory tests

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

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Overview

• There are basically no confirmatory blood studies.

• Patients usually have a moderate leukocytosis (< 20k), yet up to 40% can have a normal WBC count.
• The ESR is usually elevated in the 40 – 50 range, but again, can also be normal.
• Blood cultures are usually negative, but should be obtained just in case they are positive.
• The LP is usually not helpful, and the risks are thought to outweigh the benefits.

• If done, the protein and cell counts are usually elevated and CSF Cx are usually negative.

• Obtaining tissue is obviously the gold standard and will demonstrate the pathogen in close to 100% of cases.