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

In patients with known or suspected abscesses, the use of lumbar puncture is contraindicated. 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  cerebral spinal fluid (CSF) are nonspecific. 

• Patients usually have a moderate leukocytosis (< 20k), yet up to 40% can have a normal WBC count.
• The erythrocyte sedimentation rate (ESR) is usually elevated in the 40 – 50 range, but again, can also be normal.
• Electroencephalogram (EEG) is abnormal in most patients as the brain abscess lateralizes to the side of the lesion.
• Obtaining tissue is demonstrates the pathogen in close to 100% of cases.