Epidural abscess laboratory findings: Difference between revisions

Jump to navigation Jump to search
Line 6: Line 6:
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 and posteriorly supported by laboratory tests and imaging studies, however it can only be confirmed after surgical drainage and proper study of the collected material. 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>
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 and posteriorly supported by laboratory tests and imaging studies, however it can only be confirmed after surgical drainage and proper study of the collected material. 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==
==Laboratory Findings==
[[Inflammatory]] markers may be elevated, however it isn't always the case, nor is there a specific marker to confirm the [[diagnosis]]. Therefore laboratory results should be used, along with clinical findings to help in the [[diagnosis]], but 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>
[[Inflammatory]] markers may be elevated, however it 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 along clinical findings to help in the [[diagnosis]], but 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>
*[[Leukocytosis]] ''(about 2/3 of patients)''
*[[Leukocytosis]] ''(about 2/3 of patients)''
*Elevated [[Erythrocyte Sedimentation Rate]]
*Elevated [[Erythrocyte Sedimentation Rate]]
*Elevated [[C-reactive protein]]
*Elevated [[C-reactive protein]]
*[[Bacteremia]], detected in about 60% of patients may be the cause or be originated in the abscess, more commonly ''[[Staphylococcus aureus]]''
*[[Bacteremia]], detected in about 60% of patients may be the cause or be originated in the abscess, more commonly ''[[Staphylococcus aureus]]''
*Possible thrombocytopenia, ''particularly in adults'' <ref name="Grewal2006">{{cite journal|last1=Grewal|first1=S.|title=Epidural abscesses|journal=British Journal of Anaesthesia|volume=96|issue=3|year=2006|pages=292–302|issn=0007-0912|doi=10.1093/bja/ael006}}</ref>
*Thrombocytosis, ''particullarly in children'' <ref name="Grewal2006">{{cite journal|last1=Grewal|first1=S.|title=Epidural abscesses|journal=British Journal of Anaesthesia|volume=96|issue=3|year=2006|pages=292–302|issn=0007-0912|doi=10.1093/bja/ael006}}</ref>


==References==
==References==

Revision as of 02:25, 26 March 2014

Epidural abscess Microchapters

Home

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Epidural abscess from other Diseases

Epidemiology and Demographics

Risk Factors

Natural History, Complications and Prognosis

Diagnosis

History and Symptoms

Physical Examination

Laboratory Findings

CT

MRI

Other Imaging Findings

Other Diagnostic Studies

Treatment

Medical Therapy

Surgery

Primary Prevention

Secondary Prevention

Cost-Effectiveness of Therapy

Future or Investigational Therapies

Case Studies

Case #1

Epidural abscess laboratory findings On the Web

Most recent articles

Most cited articles

Review articles

CME Programs

Powerpoint slides

Images

American Roentgen Ray Society Images of Epidural abscess laboratory findings

All Images
X-rays
Echo & Ultrasound
CT Images
MRI

Ongoing Trials at Clinical Trials.gov

US National Guidelines Clearinghouse

NICE Guidance

FDA on Epidural abscess laboratory findings

CDC on Epidural abscess laboratory findings

Epidural abscess laboratory findings in the news

Blogs on Epidural abscess laboratory findings

Directions to Hospitals Treating Epidural abscess

Risk calculators and risk factors for Epidural abscess laboratory findings

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: João André Alves Silva, M.D. [2]

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. [1] It may occur in two different places: 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 and posteriorly supported by laboratory tests and imaging studies, however it can only be confirmed after surgical drainage and proper study of the collected material. According to the location of the collection, the abscess may have different origins, different organisms involved, symptoms, evolutions, complications and therapeutical techniques. [2][3]

Laboratory Findings

Inflammatory markers may be elevated, however it 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 along clinical findings to help in the diagnosis, but are still not sufficient, they should then be complemented by imaging studies. [3]

  • Thrombocytosis, particullarly in children [4]

References

  1. Longo, Dan L. (Dan Louis) (2012). Harrison's principles of internal medici. New York: McGraw-Hill. ISBN 978-0-07-174889-6.
  2. Danner, R. L.; Hartman, B. J. (1987). "Update of Spinal Epidural Abscess: 35 Cases and Review of the Literature". Clinical Infectious Diseases. 9 (2): 265–274. doi:10.1093/clinids/9.2.265. ISSN 1058-4838.
  3. 3.0 3.1 Darouiche, Rabih O. (2006). "Spinal Epidural Abscess". New England Journal of Medicine. 355 (19): 2012–2020. doi:10.1056/NEJMra055111. ISSN 0028-4793.
  4. 4.0 4.1 Grewal, S. (2006). "Epidural abscesses". British Journal of Anaesthesia. 96 (3): 292–302. doi:10.1093/bja/ael006. ISSN 0007-0912.