Epidural abscess other diagnostic studies: Difference between revisions
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__NOTOC__ | __NOTOC__ | ||
{{Epidural abscess}} | {{Epidural abscess}} | ||
{{CMG}} | {{CMG}} {{AE}} {{JS}}; {{AG}} | ||
==Overview== | ==Overview== | ||
[[Lumbar puncture]] is likely not helpful in the diagnosis of epidural abscess. | |||
==Lumbar Puncture== | ==Other Diagnostic Studies== | ||
[[ | ===Lumbar Puncture=== | ||
* | [[Lumbar puncture]] is likely not helpful in the diagnosis of epidural abscess. [[Cerebrospinal fluid]] study is not routinely performed because it offers little information, and has high associated risks. It should be analyzed only when [[myelography]] is performed. Approximately 75% of patients whose cerebrospinal fluid is studied demonstrate: | ||
*[[ | *High [[protein]] level | ||
*[[Pleocytosis]], with either [[polymorphonuclear cells|polymorphonuclear]] or [[mononuclear cells|mononuclear]] predominance | |||
These findings, although suggestive of parameningeal [[infection]], are not specific of epidural infection. The Gram-stain results of the cerebrospinal fluid are positive in approximately 19% of cases, while the majority of tests return Gram-negative.<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><ref name="pmid1359381">{{cite journal| author=Darouiche RO, Hamill RJ, Greenberg SB, Weathers SW, Musher DM| title=Bacterial spinal epidural abscess. Review of 43 cases and literature survey. | journal=Medicine (Baltimore) | year= 1992 | volume= 71 | issue= 6 | pages= 369-85 | pmid=1359381 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=1359381 }} </ref> The risks associated with lumbar puncture include:<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><ref name="pmid1359381">{{cite journal| author=Darouiche RO, Hamill RJ, Greenberg SB, Weathers SW, Musher DM| title=Bacterial spinal epidural abscess. Review of 43 cases and literature survey. | journal=Medicine (Baltimore) | year= 1992 | volume= 71 | issue= 6 | pages= 369-85 | pmid=1359381 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=1359381 }} </ref><ref name="pmid2385333">{{cite journal| author=Hlavin ML, Kaminski HJ, Ross JS, Ganz E| title=Spinal epidural abscess: a ten-year perspective. | journal=Neurosurgery | year= 1990 | volume= 27 | issue= 2 | pages= 177-84 | pmid=2385333 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=2385333 }} </ref> | |||
*Inducing [[meningitis]] | |||
*[[Subdural infection]] if the needle transverses the epidural abscess | |||
*Inducing neurologic deterioration if lumbar puncture is performed below a complete spinal subarachnoid block | |||
==References== | ==References== | ||
{{Reflist|2}} | {{Reflist|2}} | ||
[[Category:Infectious disease]] | [[Category:Infectious disease]] | ||
[[Category:Disease]] | [[Category:Disease]] | ||
[[Category:Neurology]] | [[Category:Neurology]] | ||
[[Category:Primary care]] | [[Category:Primary care]] | ||
Revision as of 21:01, 16 November 2015
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Epidural abscess Microchapters |
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Epidural abscess other diagnostic studies On the Web |
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American Roentgen Ray Society Images of Epidural abscess other diagnostic studies |
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Risk calculators and risk factors for Epidural abscess other diagnostic studies |
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
Lumbar puncture is likely not helpful in the diagnosis of epidural abscess.
Other Diagnostic Studies
Lumbar Puncture
Lumbar puncture is likely not helpful in the diagnosis of epidural abscess. Cerebrospinal fluid study is not routinely performed because it offers little information, and has high associated risks. It should be analyzed only when myelography is performed. Approximately 75% of patients whose cerebrospinal fluid is studied demonstrate:
- High protein level
- Pleocytosis, with either polymorphonuclear or mononuclear predominance
These findings, although suggestive of parameningeal infection, are not specific of epidural infection. The Gram-stain results of the cerebrospinal fluid are positive in approximately 19% of cases, while the majority of tests return Gram-negative.[1][2] The risks associated with lumbar puncture include:[1][2][3]
- Inducing meningitis
- Subdural infection if the needle transverses the epidural abscess
- Inducing neurologic deterioration if lumbar puncture is performed below a complete spinal subarachnoid block
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 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.
- ↑ Hlavin ML, Kaminski HJ, Ross JS, Ganz E (1990). "Spinal epidural abscess: a ten-year perspective". Neurosurgery. 27 (2): 177–84. PMID 2385333.