Epidural abscess laboratory findings: Difference between revisions

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__NOTOC__
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{{Epidural abscess}}
{{Epidural abscess}}
{{CMG}}; {{AE}} {{JS}}
{{CMG}} {{AE}} {{JS}}; {{AG}}


==Overview==
==Overview==
An epidural abscess is a rare [[suppurative]] [[infection]] of the [[central nervous system]], a collection of [[pus]] localised in the [[epidural space]] lying outside the [[dura mater]], which accounts for less than 2% of focal [[CNS]] infections. <ref>{{Cite book  | last1 = Longo | first1 = Dan L. (Dan Louis) | title = Harrison's principles of internal medici | date = 2012 | publisher = McGraw-Hill | location = New York | isbn = 978-0-07-174889-6 | pages =  }}</ref> It may occur in two different places: [[intracranial space|intracranially]] or in the [[spinal canal]].  Because the initial [[symptoms]] and clinical characteristics are not always identical, and are similar to the ones in other diseases, along with the fact that they are both rare conditions, the final [[diagnosis]] might be delayed in time. This late [[diagnosis]] comes at great cost to the patient, since it is usually accompanied by a bad [[prognosis]] and severe [[complications]] with a potential fatal outcome. The [[diagnosis]] of [[epidural abscess]] should be first suspected from the clinical findings, being posteriorly supported by laboratory tests and imaging studies, however it can only be confirmed after [[surgical]] drainage and proper study of the collected material. The laboratory tests despite helpful, are not diagnostic and should always be used alongside with history taking, clinical examination and imaging studies. According to the location of the collection, the [[abscess]] may have different origins, different organisms involved, [[symptoms]],  evolutions, [[complications]] and therapeutical techniques. <ref name="DannerHartman1987">{{cite journal|last1=Danner|first1=R. L.|last2=Hartman|first2=B. J.|title=Update of Spinal Epidural Abscess: 35 Cases and Review of the Literature|journal=Clinical Infectious Diseases|volume=9|issue=2|year=1987|pages=265–274|issn=1058-4838|doi=10.1093/clinids/9.2.265}}</ref><ref name="Darouiche2006">{{cite journal|last1=Darouiche|first1=Rabih O.|title=Spinal Epidural Abscess|journal=New England Journal of Medicine|volume=355|issue=19|year=2006|pages=2012–2020|issn=0028-4793|doi=10.1056/NEJMra055111}}</ref>
Laboratory findings consistent with the diagnosis of epidural abscess include [abnormal test 1], [abnormal test 2], and [abnormal test 3].


==Laboratory Findings==
==Laboratory Findings==
[[Inflammatory]] markers may be elevated, however this isn't always the case, nor is there a specific marker to confirm the [[diagnosis]]. Therefore laboratory results, despite helpful are not diagnostic and should be used alongside clinical findings to help in the [[diagnosis]], nevertheless are still not sufficient, they should then be complemented by imaging studies. <ref name="Darouiche2006">{{cite journal|last1=Darouiche|first1=Rabih O.|title=Spinal Epidural Abscess|journal=New England Journal of Medicine|volume=355|issue=19|year=2006|pages=2012–2020|issn=0028-4793|doi=10.1056/NEJMra055111}}</ref> Common abnormal markers in this condition are:
Laboratory findings consistent with the diagnosis of epidural abscess include [abnormal test 1], [abnormal test 2], and [abnormal test 3].
*Elevated [[Erythrocyte Sedimentation Rate]]
 
===Erythrocyte Sedimentation Rate===
An elevated [[erythrocyte sedimentation rate]] is observed in about 2/3 of patients.<ref name="Darouiche2006">{{cite journal|last1=Darouiche|first1=Rabih O.|title=Spinal Epidural Abscess|journal=New England Journal of Medicine|volume=355|issue=19|year=2006|pages=2012–2020|issn=0028-4793|doi=10.1056/NEJMra055111}}</ref> This, however, is not always indicative of epidural
 
 
 
===C-Reactive Protein===
 
===Leukocytosis===
 
===Platelet count===
 
[[Inflammatory]] markers may be elevated, however this isn't always the case, nor is there a specific marker to confirm the [[diagnosis]]. Therefore laboratory results, despite helpful are not diagnostic and should be used alongside clinical findings to help in the [[diagnosis]], nevertheless are still not sufficient, they should then be complemented by imaging studies. <ref name="Darouiche2006">{{cite journal|last1=Darouiche|first1=Rabih O.|title=Spinal Epidural Abscess|journal=New England Journal of Medicine|volume=355|issue=19|year=2006|pages=2012–2020|issn=0028-4793|doi=10.1056/NEJMra055111}}</ref> Common abnormal markers in this condition are:
 
*Elevated [[C-reactive protein]]
*Elevated [[C-reactive protein]]
*[[Leukocytosis]] ''(about 2/3 of patients)''
*[[Leukocytosis]] ''(about 2/3 of patients)''
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{{Reflist|2}}
{{Reflist|2}}


[[Category:Wikinfect]]
[[Category:Infectious disease]]
[[Category:Infectious disease]]
[[Category:Disease]]
[[Category:Disease]]
[[Category:Neurology]]
[[Category:Neurology]]
[[Category:Primary care]]
[[Category:Primary care]]

Revision as of 20:30, 13 November 2015

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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 [abnormal test 1], [abnormal test 2], and [abnormal test 3].

Laboratory Findings

Laboratory findings consistent with the diagnosis of epidural abscess include [abnormal test 1], [abnormal test 2], and [abnormal test 3].

Erythrocyte Sedimentation Rate

An elevated erythrocyte sedimentation rate is observed in about 2/3 of patients.[1] This, however, is not always indicative of epidural


C-Reactive Protein

Leukocytosis

Platelet count

Inflammatory markers may be elevated, however this isn't always the case, nor is there a specific marker to confirm the diagnosis. Therefore laboratory results, despite helpful are not diagnostic and should be used alongside clinical findings to help in the diagnosis, nevertheless are still not sufficient, they should then be complemented by imaging studies. [1] Common abnormal markers in this condition are:

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 CSF. In the case of material from the abscess, the chance of finding the responsible organism is about 90%, in the blood 62% and in the CSF about 19%. [3]

References

  1. 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. 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.
  3. 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.