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Epidural abscess other diagnostic studies

Introduction

Overview

Overview

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.

Other Diagnostic Studies

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:

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

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. ISSNΒ 0028-4793.
  2. ↑ 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. PMIDΒ 1359381.
  3. ↑ Hlavin ML, Kaminski HJ, Ross JS, Ganz E (1990). “Spinal epidural abscess: a ten-year perspective”. Neurosurgery. 27 (2): 177–84. PMIDΒ 2385333.

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: JoΓ£o AndrΓ© Alves Silva, M.D. [2]; Anthony Gallo, B.S. [3]