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.